Section H - effective 1 March 2009 (text extract)

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Contents

Introducing PHARMAC ..........................................................................................................................2 Members of the PHARMAC Board ....................................................................................................2 Decision Criteria ..............................................................................................................................2 PHARMAC and Section H of the Pharmaceutical Schedule ...................................................................3 The PHARMAC Hospital Team..........................................................................................................3 PHARMAC’s clinical advisors ...........................................................................................................4 Pharmacology and Therapeutics Advisory Committee (PTAC)...........................................................4 Hospital Pharmaceuticals Advisory Committee (HPAC).....................................................................4 Purpose of the Pharmaceutical Schedule .............................................................................................5 Finding Information in the Pharmaceutical Schedule .........................................................................5 Community Pharmaceuticals............................................................................................................5 Hospital Pharmaceuticals .................................................................................................................5 Explaining hospital pharmaceutical entries ........................................................................................6 Hospital Pharmaceutical and Pharmaceutical Cancer Treatment Costs ..............................................7 PHARMAC website ..........................................................................................................................7 Exceptional Circumstances policies ..................................................................................................7 Hospital Exceptional Circumstances (HEC) .......................................................................................8 Community Exceptional Circumstances (CEC) ..................................................................................8 Cancer Exceptional Circumstances (CaEC) .......................................................................................9 Part I – General Rules for Hospital Pharmaceuticals ..........................................................................10 Introduction ...................................................................................................................................10 1. Interpretation and Definitions ......................................................................................................10 2. Current Hospital Pharmaceutical Contracts .................................................................................12 3. National Contract Pharmaceutical Price ......................................................................................13 4. Hospital Supply Status (HSS) .....................................................................................................13 5. Collection of rebates and payment of financial compensation......................................................14 6. Price and Volume Data ...............................................................................................................14 7. Assessed Pharmaceuticals ........................................................................................................14 8. Discretionary Community Supply Pharmaceuticals .....................................................................14 9. Pharmaceuticals Cancer Treatments ..........................................................................................15 10. Practitioners prescribing unapproved Pharmaceuticals .............................................................15 Part II - Pharmaceuticals Under National Contracts ...........................................................................17 Hospital Supply Status Products – cumulative to July 2008 ............................................................17 Pharmaceuticals Under National Contracts .....................................................................................27 Part III – Hospital Pharmaceuticals Assessed by PHARMAC ..............................................................75 Assessments in 2006 ....................................................................................................................75 Assessments in 2005 ....................................................................................................................76 Assessments in 2004 ....................................................................................................................77 Assessments in 2003 ....................................................................................................................78 Assessments in 2003 continued ....................................................................................................79 Part IIIb – Preliminary Pharmaceutical Assessments .......................................................................80 The Hospital Pharmaceutical Assessment Process (HPAP).............................................................81 Part IV – Discretionary Community Supply Pharmaceuticals ............................................................82 Index ...................................................................................................................................................87

Introducing PHARMAC

PHARMAC, the Pharmaceutical Management Agency, is a Crown entity established pursuant to the New Zealand Public Health and Disability Act 2000 (the Act). The primary objective of PHARMAC is to secure for eligible people in need of pharmaceuticals, the best health outcomes that are reasonably achievable from pharmaceutical treatment and from within the amount of funding provided. The PHARMAC Board consists of up to six members appointed by the Minister of Health. All decisions relating to PHARMAC’s operation are made by or under the authority of the Board. In particular, Board members decide on the strategic direction of PHARMAC and may decide which community pharmaceuticals should be subsidised and at what levels, and determine national prices for some pharmaceuticals to be purchased by and used in DHB Hospitals, and whether or not special conditions are to be applied to such purchases.

Members of the PHARMAC Board

Richard Waddel Gregor Coster Kura Denness David Kerr David Moore Adrienne von Tunzelmann Decisions taken by the PHARMAC Board members, or made under the authority of the Board, incorporate a balanced view of the needs of prescribers and patients. The aim is to achieve long-term gains and efficient ways of making pharmaceuticals available to the community and for DHB Hospitals to purchase them. The functions of PHARMAC are to perform the following, within the amount of funding provided to it in the Pharmaceutical Budget or to DHBs from their own budgets for the use of pharmaceuticals in their hospitals, as applicable, and in accordance with its annual plan and any directions given by the Minister (Section 103 of the Crown Entities Act): a) to maintain and manage a pharmaceutical schedule that applies consistently throughout New Zealand, including determining eligibility and criteria for the provision of subsidies; b) to manage incidental matters arising out of (a), including in exceptional circumstances providing for subsidies for the supply of pharmaceuticals not on the pharmaceutical schedule; c) to engage as it sees fit, but within its operational budget, in research to meet its objectives as set out in Section 47(a) of the Act; d) to promote the responsible use of pharmaceuticals; e) to manage the purchasing of any or all pharmaceuticals, whether used either in a hospital or outside it, on behalf of DHBs; f) any other functions given to PHARMAC by or under any enactment or authorised by the Minister. The policies and criteria set out in the Pharmaceutical Schedule and PHARMAC’s Operating Policies and Procedures arise out of, and are designed to help PHARMAC achieve and perform, PHARMAC’s objective and functions under the Act. However PHARMAC may, having regard to its public law obligations, depart from the strict application of those policies and criteria in certain exceptional cases where it considers this necessary or appropriate in the proper exercise of its statutory discretion and to give effect to its objective and functions, particularly with respect to: • Determining eligibility and criteria for the provision of subsidies: and • In exceptional circumstances providing for subsidies for the supply of pharmaceuticals not on the Pharmaceutical Schedule.

Decision Criteria

PHARMAC updates the Pharmaceutical Schedule at regular intervals to notify prescribers, pharmacists, hospital managers and patients of changes to Community Pharmaceutical subsidies and the prices for Hospital Pharmaceuticals. In making decisions about amendments to the Pharmaceutical Schedule, PHARMAC is guided by its Operating Policies and Procedures, as amended or supplemented from time to time. The criteria for decisions about proposed amendments to the schedule are: 2

(a) (b) (c) (d) (e) (f) (g) (h) (i)

the health needs of all eligible people within New Zealand; the particular health needs of Maori and Pacific peoples; the availability and suitability of existing medicines, therapeutic medical devices and related products and related things; the clinical benefits and risks of pharmaceuticals; the cost-effectiveness of meeting health needs by funding pharmaceuticals rather than using other publicly funded health and disability support services; the budgetary impact (in terms of the pharmaceutical budget and the Government’s overall health budget) of any changes to the Schedule; the direct cost to health service users; the Government’s priorities for health funding, as set out in any objectives notified by the Crown to PHARMAC, or in PHARMAC’s Funding Agreement, or elsewhere; and such other criteria as PHARMAC thinks fit. PHARMAC will carry out appropriate consultation when it intends to take any such “other criteria” into account.

The Operating Policies and Procedures, including any supplements, also describe the way in which PHARMAC determines the level of subsidy or purchase price payable for each Community Pharmaceutical or Hospital Pharmaceutical, respectively. Copies of PHARMAC’s Operating Policies and Procedures and of any applicable supplements are available on the PHARMAC website, or on request.

PHARMAC and Section H of the Pharmaceutical Schedule

PHARMAC manages the national Pharmaceutical Schedule, which lists: • Pharmaceuticals available in the community and subsidised by the Government with funding from the Pharmaceutical Budget; and • some Pharmaceuticals purchased by DHBs for use in their hospitals, and includes those Hospital Pharmaceuticals for which national prices have been negotiated by PHARMAC. In the community approximately 1848 Pharmaceuticals are subsidised by the Government. Most are available to all eligible people within New Zealand on prescription by a medical doctor. Some are listed with guidelines or conditions such as ‘only if prescribed for a dialysis patient’ or ‘Special Authority – Retail Pharmacy’, to ensure that Pharmaceuticals are used by those people who are most likely to benefit from them. Pharmaceuticals provided to patients for use while in DHB Hospitals are not covered by Sections A to G of the Pharmaceutical Schedule. Section H of the Pharmaceutical Schedule includes Pharmaceuticals that can be purchased at a national price by DHBs for use in their hospitals. These are referred to as National Contract Pharmaceuticals. Section H of the Pharmaceutical Schedule also identifies Pharmaceutical Cancer Treatments that DHBs have been directed to fund for use in their hospitals and/or in association with services provided in their hospitals, as well as new Pharmaceuticals used in hospitals, which have been or are being assessed by PHARMAC, the results of that analysis being available to DHB Hospitals via PHARMAC’s website. A list of Discretionary Community Supply Pharmaceuticals, in Section H of the Pharmaceutical Schedule identifies those products that currently are not subsidised from the Pharmaceutical Budget as Community Pharmaceuticals in Sections A to G of the Pharmaceutical Schedule but which DHBs can at their discretion fund for use in the community from their own budgets without specific Hospital Exceptional Circumstances approval.

The PHARMAC Hospital Team

Steffan Crausaz Andrew Davies Rachel Grocott Rachel Pratt Manager, Funding and Procurement Procurement Initiatives Manager Health Economist/Team Leader, Assessment Hospital Exceptional Circumstances Panel Co-ordinator

PHARMAC’s clinical advisors Pharmacology and Therapeutics Advisory Committee (PTAC)

PHARMAC works closely with the Pharmacology and Therapeutics Advisory Committee (PTAC), an expert medical committee which provides independent advice to PHARMAC on health needs and the clinical benefits of particular pharmaceuticals for use in the community and/or in DHB Hospitals. The committee members are all senior, practising clinicians. The chair of PTAC sits with the PHARMAC Board in an advisory capacity. PTAC helps decide which community pharmaceuticals are to be subsidised from public monies by making recommendations to PHARMAC. Part of the role of PTAC is to review whether community pharmaceuticals already listed on the Schedule should continue to receive Government funds. The resources freed up can be used to subsidise other community pharmaceuticals with a greater therapeutic worth. PHARMAC may obtain clinical advice from PTAC in relation to national purchasing strategies for Hospital Pharmaceuticals. There may be additional specialist hospital representatives on PTAC subcommittees, or additional PTAC subcommittees, where PHARMAC considers this necessary. PTAC members are: Carl Burgess Ian Hosford Sisira Jayathissa Peter Jones Jim Lello Graham Mills Peter Pillans Paul Tomlinson Howard Wilson Mark Weatherall George Laking Contact PTAC C/MBChB, MD, MRCP (UK), FRACP, FRCP, physician/clinical pharmacologist, Chair MBChB, FRANZCP, psychiatrist MBBS, MD, MRCP, FAFPHM, FRCP, FRACP, physician BMedSci, MBChB, PhD, FRCP, FRACP, physician BHB, MBChB, DCH, FRNZCGP, general practitioner MBChB, MTropHlth, MD, FRACP, infectious diseases specialist and general physician MBBCh, MD, FCP, FRACP, clinical pharmacologist MBChB, MD, MRCP, FRACP, BSc, paediatrician, Deputy Chair BSc, PhD, MB, BS, Dip Obst, FRNZCGP, general practitioner BA, MBChB, MApplStats, FRACP PhD, MB, B.Med.Sci, MD, FRACP Advisory Committee Manager Pharmaceutical Management Agency PO Box 10 254, WELLINGTON PTAC@pharmac.govt.nz

Hospital Pharmaceuticals Advisory Committee (HPAC)

The Hospital Pharmaceutical Advisory Committee (HPAC) is a committee made up of representatives from DHBs, as nominated by DHBs and appointed by the PHARMAC Board. As part of the National Hospital Pharmaceutical Strategy Review in late 2004 a decision was made to seek new nominations for HPAC. The PHARMAC Board has appointed the following members to HPAC: Neil Aitcheson Paul Barrett Sarah Fitt Jan Goddard David Ryan Simon Donlevy Chris Morgan Materials Manager Pharmacy Services Manager Pharmacy Manager Pharmacy Services Pharmacy Operations Manager Pharmacy Manager Materials Manager MidCentral Canterbury Auckland Waikato Waitemata Southland Auckland

Contact HPAC C/- Manager, Funding and Procurement Pharmaceutical Management Agency PO Box 10 254, WELLINGTON

Purpose of the Pharmaceutical Schedule

The purpose of the Schedule is to list: • the Community Pharmaceuticals that are subsidised by the Government and to show the amount of the subsidy paid to contractors, as well as the manufacturer’s price and any access conditions that may apply; and • some Hospital Pharmaceuticals that are purchased and used by DHB Hospitals, including those for which national prices have been negotiated by PHARMAC. The purpose of the Schedule is not to show the final cost to Government of subsidising each Community Pharmaceutical or to DHBs in purchasing each Hospital Pharmaceutical since that will depend on any rebate and other arrangements PHARMAC has with the supplier and, for some Hospital Pharmaceuticals, on any logistics arrangements put in place by individual DHB Hospitals.

Finding Information in the Pharmaceutical Schedule Community Pharmaceuticals

For Community Pharmaceuticals, the Schedule is organised in a way to help the reader find Community Pharmaceuticals, which may be used to treat similar conditions. To do this, Community Pharmaceuticals are first classified anatomically, originally based on the Anatomical Therapeutic Chemical (ATC) system, and then further classified under section headings structured for the New Zealand medical system. • Section A lists the General Rules in relation to Community Pharmaceuticals and related products. • Section B lists Community Pharmaceuticals and related products by anatomical classification, which are further divided into one or more therapeutic headings. Community Pharmaceuticals used to treat similar conditions are grouped together. • Section C lists the rules in relation to Extemporaneously Compounded Products (ECPs) and Community Pharmaceuticals that will be subsidised when extemporaneously compounded. • Section D lists the rules in relation to Special Foods and the Special Foods that are subsidised. • Section E Part I lists the Community Pharmaceuticals that are subsidised on a Practitioner’s Supply Order (PSO) and Wholesale Supply Order (WSO). • Section E Part II lists remote areas for the purpose of PSOs. • Section F lists the Community Pharmaceutical dispensing period exemptions. • Section G lists the Community Pharmaceuticals eligible for reimbursement of safety cap and related rules. The listings are displayed alphabetically (where practical) within each level of the classification system. Each anatomical section contains a series of therapeutic headings, some of which may contain a further classification level. Where a Community Pharmaceutical is used in more than one therapeutic area, they may be cross-referenced. The therapeutic headings in the Pharmaceutical Schedule do not necessarily correspond to the therapeutic groups and therapeutic subgroups, which PHARMAC establishes for the separate purpose of determining the level of subsidy to be paid for each Community Pharmaceutical. The index located at the back of the book in which Sections A–G of the Pharmaceutical Schedule are published can be used to find page numbers for generic chemical entities, or product brand names.

Hospital Pharmaceuticals

• Section H lists Pharmaceuticals that DHBs fund from their own budgets. The Hospital Pharmaceuticals are grouped into the following Parts in Section H: - Part I lists the rules in relation to Hospital Pharmaceuticals. - Part II lists Hospital Pharmaceuticals for which national contracts exist (National Contract Pharmaceuticals). These are listed alphabetically by generic chemical entity name and line item, the relevant Price negotiated by PHARMAC and, if applicable, an indication of whether it has Hospital Supply Status (HSS) and any associated Discretionary Variance (DV) Pharmaceuticals and DV Limit. - Part III lists Assessed Pharmaceuticals, which have been or are being assessed by PHARMAC and, where such assessment is available, PHARMAC’s opinion regarding the use of the Assessed Pharmaceuticals in hospitals. DHB Hospitals are not obliged to implement those recommendations. - Part IV lists Discretionary Community Supply Pharmaceuticals, which are not Community Pharmaceuticals, but which a DHB Hospital can, in its discretion, fund for use in the community from its own budget. 5

The index located at the back of Section H can be used to find page numbers for generic chemical entities, or product brand names, for Hospital Pharmaceuticals.

Explaining hospital pharmaceutical entries

Section H of the Pharmaceutical Schedule lists National Contract Pharmaceuticals, DV Pharmaceuticals, Assessed Pharmaceuticals and Discretionary Community Supply Pharmaceuticals that are available to be purchased by DHBs. Where applicable, the listing of the Hospital Pharmaceutical may have an indication of whether it has HSS (if the brand name is in bold), its Price and any associated DV Pharmaceuticals and DV Limit. Contracted Pharmaceutical Description Brand Price($) (ex man. excl. GST)

CEFACLOR MONOHYDRATE Cap 250 mg ..............................................RanbaxyCefaclor RITUXIMAB Inj 500 mg per 50 ml vial ...........................Mabthera RITONAVIR Cap 100 mg ..............................................Norvir

Per

DV Limit

DV DV Pharmaceuticals Limit applies from

Sept-07 Clorotir

28.90

100

2987.00 121.87

1 84

Apr-06

(B)

In the case of cefaclor monohydrate, Ranbaxy-Cefaclor is the Pharmaceutical with HSS. While the price indicated applies from the date on which Ranbaxy-Cefaclor cap 250 mg is listed, it does not have HSS until 1 September 2007. The 1% DV Limit means that at least 99% of the total volume of all brands of cefaclor monohydrate caps 250 mg purchased by DHB Hospitals from 1 September 2007 must be Ranbaxy-Cefaclor. Subject to the provisions of 4.2(c)(iii) of the General Rules for Hospital Pharmaceuticals, DHB Hospitals may only purchase up to 1% of other brands of cefaclor monohydrate caps 250 mg. Those other brands of cefaclor monohydrate caps 250 mg known to be available in New Zealand are listed as DV Pharmaceuticals but the 1% DV Limit also applies to any unlisted brands of cefaclor monohydrate caps 250 mg. The 5% DV Limit applying to rituximab inj 500mg per 50 ml has a similar effect as the 1% DV Limit in the cefaclor monohydrate example in that at least 95% of the total volume of all rituximab inj 500 mg per 50 ml purchased must be Mabthera. There are no other known brands of rituximab inj 500 mg per 50 ml available in New Zealand but the (B) noted under DV Pharmaceuticals indicates that DHB Hospitals are prohibited from purchasing any brands of 500 mg per 50 ml rituximab in the same or similar form distributed in New Zealand. The brand of ritonavir 100 mg capsules contracted for, Norvir, does not have HSS or any DV Limit or DV Pharmaceuticals. Accordingly, DHB Hospitals are able to buy the Norvir brand of ritonavir 100 mg capsule at the listed Price if they choose but are not prohibited from buying any other brand of the Pharmaceutical in any quantities required.

Hospital Pharmaceutical and Pharmaceutical Cancer Treatment Costs

The cost of purchasing Hospital Pharmaceuticals and Pharmaceutical Cancer Treatments (for use in DHB hospitals and/ or in association with Outpatient services provided in DHB Hospitals) is met by the Funder (in particular, the relevant DHB) from its own budget. As required by section 23(7) of the Act, in performing any of their functions in relation to the supply of Pharmaceuticals, including Pharmaceutical Cancer Treatments, DHBs must not act inconsistently with the Pharmaceutical Schedule.

PHARMAC website

Information about PHARMAC is available on its website at http://www.pharmac.govt.nz. The website includes copies of the Annual Review, Annual Report and Annual Plan, as well as information such as the Pharmaceutical Schedule, Pharmaceutical Schedule Updates, other publications and recent press releases. Copies of the February 2002 National Hospital Pharmaceutical Strategy can be found on the website. Also, for more details to that contained in Part III of Section H of the Pharmaceutical Schedule about hospital pharmaceuticals that have been assessed by PHARMAC and further information about assessments undertaken by DHB Hospitals, please refer to http://www.pharmac.govt.nz/hpad

Exceptional Circumstances policies

The purposes of the Exceptional Circumstances policies are to provide: • funding from the Community Exceptional Circumstances budget for medication, to be used in the community, in circumstances where the provision of a funded community medication is appropriate, but funding from the Pharmaceutical Budget is not able to be provided through the Pharmaceutical Schedule (“Community Exceptional Circumstances”); or • an assessment process for DHB Hospitals to determine whether they can fund medication, to be used in the community, in circumstances where the medication is neither a Community Pharmaceutical nor a Discretionary Community Supply Pharmaceutical and where the patient does not meet the criteria for Community Exceptional Circumstances (“Hospital Exceptional Circumstances”); or • an assessment process for DHB Hospitals to determine whether they can fund pharmaceuticals for the treatment of cancer in their DHB Hospital, or in association with Outpatient services provided in their DHB Hospital, in circumstances where the pharmaceutical is not identified as a Pharmaceutical Cancer Treatment (“Cancer Exceptional Circumstances”) in Sections A-H of the Pharmaceutical Schedule. Upon receipt of an application for approval for Community Exceptional Circumstances or Hospital Exceptional Circumstances, the Exceptional Circumstances Panel first decides whether an application will be assessed initially under the Community Exceptional Circumstances criteria or the Hospital Exceptional Circumstances criteria. Cancer Exceptional Circumstances is a separate process.

Hospital Exceptional Circumstances (HEC)

If the application is first assessed but not approved under the Community Exceptional Circumstances criteria, the Exceptional Circumstances Panel may recommend the funding of the pharmaceutical for use in the community by a specific patient from a DHB Hospital’s own budget under Hospital Exceptional Circumstances. If the application is first assessed under the Hospital Exceptional Circumstances criteria, the Exceptional Circumstances Panel may: a) recommend against the funding of the pharmaceutical for use in the community by a specific patient from a DHB Hospital’s own budget, in which case a DHB Hospital must not fund the pharmaceutical from its own budget; b) recommend the funding of the pharmaceutical for use in the community by a specific patient from a DHB Hospital’s own budget under Hospital Exceptional Circumstances, in which case a DHB Hospital may, but is not obliged to, fund the pharmaceutical from its own budget; c) defer its decision until further assessment under the Community Exceptional Circumstances criteria can be undertaken; or d) recommend interim funding of the pharmaceutical for use in the community by a specific patient from a DHB Hospital’s own budget under Hospital Exceptional Circumstances until further assessment under the Community Exceptional Circumstances criteria can be undertaken. Permission to fund a pharmaceutical for use in the community by a specific patient from a DHB Hospital’s own budget under Hospital Exceptional Circumstances will only be granted by PHARMAC where it has been demonstrated that such funding is cost-effective for the relevant DHB in the region in which the patient resides. If the patient being treated with a pharmaceutical under Hospital Exceptional Circumstances usually resides in a district other than that within the jurisdiction of the DHB initiating the treatment, then the DHB initiating the treatment must either agree to fund any on-going treatment required once the patient has returned to his/her usual DHB, or obtain written consent from the DHB or DHBs in which the patient will reside following the commencement of treatment.

Community Exceptional Circumstances (CEC)

In order to qualify for Community Exceptional Circumstances approval one of the following entry criteria must be met: a) the condition must be rare; or b) the reaction to alternative funded treatment must be unusual; or c) an unusual combination of circumstances applies. Rare and unusual are considered to be in the order of less than 10 people nationally. Where one of the above Community Exceptional Circumstances entry criteria is met, the application may then be further examined under supplementary criteria, assessing suitability of the pharmaceutical, clinical benefit, the cost effectiveness of the treatment, and the patient’s ability to pay for the treatment. Where these documented criteria are met, a subsidy sufficient to fully fund the pharmaceutical will be made available to the specific patient on whose behalf the application was made. Community Exceptional Circumstances funding is only available where the criteria are met and is not available for financial reasons alone.

Cancer Exceptional Circumstances (CaEC)

Permission to fund a pharmaceutical for the treatment of cancer from the Hospital’s own budget under Cancer Exceptional Circumstances will only be granted by PHARMAC where it has been demonstrated that the proposed use meets the criteria. If the patient being treated with a pharmaceutical under Cancer Exceptional Circumstances usually resides in a district other than that within the jurisdiction of the DHB initiating the treatment, then the DHB initiating the treatment must either agree to fund any on-going treatment required once the patient has returned to his/her usual DHB, or obtain written consent from the DHB or DHBs in which the patient will reside following the commencement of treatment. Applications for Community Exceptional Circumstances, Hospital Exceptional Circumstances and Cancer Exceptional Circumstances should be made on the standard application form available from the PHARMAC website www.pharmac.govt.nz or the address below: The Coordinator, Exceptional Circumstances Panel PHARMAC PO Box 10 254 Wellington Phone (04) 916 7553 CEC (04) 916 7521 HEC (04) 916 7561 CaEC or fax (09) 523 6870 Email: ecpanel@pharmac.govt.nz

Treatment considered with an unfunded pharmaceutical

Yes

Is the patient currently being treated at a public hospital (either as an in-patent or out patient )

Is the pharmaceutical for the treatment of cancer?

Is the condition for the proposed use of the pharmaceutical rare (prevalence less than 10 in NZ)? No

Yes

Yes Consider under Cancer EC (CaEC) criteria; use CaEC form

Consider under Hospital EC (HEC) criteria

Consider under Community EC (CEC) criteria

Meets CaEC Criteria? No Yes

HEC panel review application

No (needs CEC/HEC form)

Yes

Is it cost-effective for the hospital to fund for use in the community?

No No

Meets CEC Criteria?

Yes

Has this application prev iously been declined under HEC criteria? Yes

Approve under CaEC. Recommend hospital funds entire course

Approve under HEC EC panel recommends hospital funds entire course

Decline application

Approve under CEC

Part I – General Rules for Hospital Pharmaceuticals

Introduction

Section H contains general rules that apply, and other information relating, to Hospital Pharmaceuticals. The amounts payable by a DHB to the relevant pharmaceutical supplier are based on the contractual arrangements between PHARMAC and the relevant pharmaceutical supplier for a national price for that National Contract Pharmaceutical. The Pharmaceutical Schedule shows the national price at which the National Contract Pharmaceutical can be purchased by DHBs, providers of logistics services, wholesalers or other such distributors, or Contract Manufacturers directly from the pharmaceutical supplier. As required by section 23(7) of the Act, in performing any of its functions in relation to the supply of Pharmaceuticals, DHBs must not act inconsistently with the Schedule.

1. Interpretation and Definitions

1.1 In this Schedule, unless the context otherwise requires: “Act” means the New Zealand Public Health and Disability Act 2000. “Assessed Pharmaceuticals” means the list of Pharmaceuticals set out in Section H Part III of the Schedule, that have been or are being assessed by PHARMAC. “Cancer Exceptional Circumstances” means the policies and criteria administered by PHARMAC relating to the ability to fund, from a DHB hospital’s own budget, pharmaceuticals for the treatment of cancer that are not identified as Pharmaceutical Cancer Treatments in Sections A-H of the Pharmaceutical Schedule. “Community Exceptional Circumstances” means the policies and criteria administered by the Exceptional Circumstances Panel relating to funding from the Community Exceptional Circumstances budget for medication, to be used in the community, in circumstances where the provision of a funded community medication is appropriate, but funding from the Pharmaceutical Budget is not able to be provided through the Pharmaceutical Schedule. “Community Pharmaceutical” means a Pharmaceutical listed in Sections A to G of the Pharmaceutical Schedule that is subsidised by the Funder from the Pharmaceutical Budget for use in the community. “Contract Manufacturer” means a manufacturer or a supplier that is a party to a contract with the relevant DHB Hospital to compound Hospital Pharmaceuticals, on request from that DHB Hospital. “Designated Delivery Point” means at a DHB Hospital’s discretion: (a) a delivery point agreed between a pharmaceutical supplier and the relevant DHB Hospital, to which delivery point that pharmaceutical supplier must supply the Pharmaceutical directly at the Price; and/or (b) any delivery point designated by the relevant DHB Hospital or PHARMAC, such delivery point being within 30 km of the relevant pharmaceutical supplier’s national distribution centre. “DHB” means an organisation established as a District Health Board by or under Section 19 of the Act. “DHB Hospital” means a DHB, including its hospital or associated provider unit that the DHB purchases Hospital Pharmaceuticals for. “Discretionary Community Supply Pharmaceuticals” means the list of Pharmaceuticals set out in Section H Part IV of the Schedule, which may be funded by a DHB Hospital from its own budget for use in the community. “DV Limit” means, for a particular Hospital Pharmaceutical with HSS, the National DV Limit or the Individual DV Limit. “DV Pharmaceutical” means a discretionary variance Pharmaceutical, that does not have HSS and which: (a) is either listed in Section H Part II of the Schedule as being a DV Pharmaceutical in association with the relevant Hospital Pharmaceutical with HSS; or (b) is the same chemical entity, at the same strength, and in the same or a similar presentation or form, as the relevant Hospital Pharmaceutical with HSS, but which is not yet listed as being a DV Pharmaceutical. “Exceptional Circumstances Panel” means the panel of clinicians, appointed by the PHARMAC Board, that is responsible for administering policies in relation to Community Exceptional Circumstances and Hospital Exceptional Circumstances. “Funder” means the body or bodies responsible, pursuant to the Act, for the funding of Pharmaceuticals listed on the Schedule (which may be one or more DHBs and/or the Ministry of Health) and their successors. 10

“GST” means goods and services tax under the Goods and Services Tax Act 1985. “Hospital Exceptional Circumstances” means the policies and criteria administered by the Exceptional Circumstances Panel relating to the ability to fund, from a DHB Hospital’s own budget, pharmaceuticals for use in the community by a specific patient where a subsidy is not available from the Pharmaceutical Budget or under Community Exceptional Circumstances. “Hospital Pharmaceuticals” means National Contract Pharmaceuticals, DV Pharmaceuticals, Discretionary Community Supply Pharmaceuticals and Assessed Pharmaceuticals. “HSS” means hospital supply status, the status of being the brand of the relevant Hospital Pharmaceutical listed in Section H Part II as HSS, that DHBs are obliged to purchase subject to any DV Limit for that Hospital Pharmaceutical for the period of hospital supply, as awarded under an agreement between PHARMAC and the relevant pharmaceutical supplier. “Individual DV Limit” means, for a particular Hospital Pharmaceutical with HSS and a particular DHB Hospital, the discretionary variance limit, being the specified percentage of that DHB Hospital’s Total Market Volume up to which that DHB Hospital may purchase DV Pharmaceuticals of that Hospital Pharmaceutical. “National Contract Pharmaceutical” means a Hospital Pharmaceutical for which PHARMAC has negotiated a national contract and the Price. “National DV Limit” means, for a particular Hospital Pharmaceutical with HSS, the discretionary variance limit, being the specified percentage of the Total Market Volume up to which all DHB Hospitals may collectively purchase DV Pharmaceuticals of that Hospital Pharmaceutical. “Outpatient”, in relation to a Community Pharmaceutical, means a person who, as part of treatment at a hospital or other institution under the control of a DHB, is prescribed the Community Pharmaceutical for consumption or use in the person’s home. “PHARMAC” means the Pharmaceutical Management Agency established by Section 46 of the Act (PHARMAC). “Pharmacode” means the six or seven digit identifier assigned to a Pharmaceutical and notified to a pharmaceutical supplier by the Pharmacy Guild. “Pharmaceutical” means a medicine, therapeutic medical device, or related product or related thing listed in Sections B to H of the Schedule. “Pharmaceutical Budget” means the pharmaceutical budget set for PHARMAC by the Crown for the subsidised supply of Community Pharmaceuticals. “Pharmaceutical Cancer Treatments” means Pharmaceutical for the treatment of cancer, listed in Sections A to G of the Schedule and identified therein as a “PCT” or “PCT only” Pharmaceutical that DHBs must fund,

from their own budgets, for use in their hospitals, and/or in association with Outpatient services provided in their DHB Hospitals, in relation to the treatment of cancers.

“Price” means the standard national price, and, unless agreed otherwise between PHARMAC and the pharmaceutical supplier, includes any costs associated with the supply of a National Contract Pharmaceutical listed in Section H Part II of the Pharmaceutical Schedule to, at a DHB Hospital’s discretion, any Designated Delivery Point, or to a Contract Manufacturer (expressly for the purpose of compounding). “Schedule” means this Pharmaceutical Schedule and all its sections and appendices. “Section B” of this Pharmaceutical Schedule means the list of Community Pharmaceuticals eligible for Subsidies included in the Schedule. “Section C” of this Pharmaceutical Schedule means the list of community extemporaneously compounded preparations and galenicals eligible for Subsidies included in the Schedule. “Section D” of this Pharmaceutical Schedule means the list of community special foods eligible for Subsidies included in the Schedule. “Section E Part I” of this Pharmaceutical Schedule means the list of Community Pharmaceuticals eligible for Subsidies and available on a Practitioner’s Supply Order or a Wholesale Supply Order included in the Schedule. “Section E Part II” of this Pharmaceutical Schedule means the list of remote areas for the purpose of community Practitioner’s Supply Orders included in the Schedule. “Section F Part I” of this Pharmaceutical Schedule means the part of Section F relating to the exemption from dispensing in Monthly Lots, and requirement to dispense in 90 Day Lots, in respect of the Community Pharmaceuticals referred to in this part of Section F;

“Section F Part II” of this Pharmaceutical Schedule means the part of Section F relating to the exemption from dispensing in Monthly Lots in respect of the Community Pharmaceuticals referred to in this part of Section F; “Section G” of this Pharmaceutical Schedule means the list of Community Pharmaceuticals eligible for reimbursement of safety Cap. “Section H” of this Pharmaceutical Schedule means the general rules for Hospital Pharmaceuticals and the lists of National Contract Pharmaceuticals and any associated DV Pharmaceuticals, of Discretionary Community Supply Pharmaceuticals and Assessed Pharmaceuticals included in Section H of the Schedule. “Section H Part I” of this Pharmaceutical Schedule means the general rules for Hospital Pharmaceuticals. “Section H Part II” of this Pharmaceutical Schedule means the list of National Contract Pharmaceuticals, the relevant Price, an indication of whether the Pharmaceutical has HSS and any associated DV Pharmaceuticals and DV Limit. “Section H Part III” of this Pharmaceutical Schedule means the list of Assessed Pharmaceuticals. “Section H Part IV” of this Pharmaceutical Schedule means the list of Discretionary Community Supply Pharmaceuticals. “Total Market Volume” means, for a particular Hospital Pharmaceutical with HSS in any given period, in accordance with the data available to PHARMAC, the sum of: a) the total number of Units of the relevant Hospital Pharmaceutical with HSS purchased by all DHB Hospitals, or by a particular DHB Hospital in the case of the Individual DV Limit; and b) the total number of Units of all the relevant DV Pharmaceuticals, listed in Section H Part II in association with that Pharmaceutical, purchased by all DHB Hospitals, or by a particular DHB Hospital in the case of the Individual DV Limit. “Unit” means an individual unit of a Pharmaceutical (e.g. tablet, 1 ml of an oral liquid, amp, syringe). “Unapproved Indication” means, for a Pharmaceutical, an indication for which it is not approved under the Medicines Act 1981. 1.2 In addition to the above interpretations and definitions, unless the content requires otherwise, a reference in the Schedule to: (a) the singular includes the plural; and (b) any legislation includes a modification and re-enactment of, legislation enacted in substitution for, and a regulation, Order in Council, and other instrument from time to time issued or made under, that legislation, where that legislation, regulation, Order in Council or other instrument has an effect on the prescribing, dispensing or subsidising of Pharmaceuticals.

2. Current Hospital Pharmaceutical Contracts

2.1 A DHB Hospital may enter into a contract for the purchase of any Pharmaceutical that is not a National Contract Pharmaceutical, provided that such contract: (a) does not oblige the relevant DHB Hospital to purchase a volume of that Pharmaceutical, if that Pharmaceutical is a DV Pharmaceutical, that is greater than the relevant DV Limit; (b) enables PHARMAC to access and use future price and volume data in respect of that Pharmaceutical; and (c) enables the relevant DHB Hospital to terminate the contract or relevant parts of the contract in order to give full effect to the national contract on 3 months’ written notice to the pharmaceutical supplier. 2.2 From the day after a DHB Hospital’s current supply contract for a chemical entity that is a National Contract Pharmaceutical expires, that DHB Hospital is to purchase the relevant National Contract Pharmaceutical listed in Section H Part II at the Price, and is to comply with the DV Limits for the National Contract Pharmaceutical where it has HSS. 2.3 Following written notification from PHARMAC that a Pharmaceutical is a National Contract Pharmaceutical, either through Section H updates or otherwise, DHB Hospitals are to take any steps available to them to terminate current contracts, and are not to enter into any new contracts or extend the period of any current contracts, for the supply of that National Contract Pharmaceutical listed in Section H Part II or the relevant chemical entity, unless PHARMAC expressly notifies otherwise.

3. National Contract Pharmaceutical Price

3.1 DHB Hospitals must take all necessary steps to enable any contracts between PHARMAC and a pharmaceutical supplier in relation to National Contract Pharmaceuticals to be given full effect. 3.2 National Contract Pharmaceuticals that can be purchased by DHBs at the relevant Price, as agreed between PHARMAC and the relevant pharmaceutical supplier, are hereby deemed to include every medicine, therapeutic medical device, or related product or related thing listed in Section H Part II of the Schedule except DV Pharmaceuticals. 3.3 A National Contract Pharmaceutical is to be made available by the relevant pharmaceutical supplier for purchase at the relevant Price by any or all of the following: a) DHB Hospitals at Designated Delivery Points; and/or b) Contract Manufacturers (expressly for the purpose of compounding).

4. Hospital Supply Status (HSS)

4.1 The DV Limit for any National Contract Pharmaceutical, which has HSS is set out beside the listing of the relevant National Contract Pharmaceutical in Section H Part II of the Schedule and may be amended from time to time. 4.2 If a National Contract Pharmaceutical is listed in Section H Part II as having HSS, DHB Hospitals: a) are expected to use up any existing stocks of DV Pharmaceuticals during the First Transition Period; b) must not purchase DV Pharmaceuticals in volumes exceeding their usual requirements, or in volumes exceeding those which they reasonably expect to use, within the First Transition Period; and c) must purchase the Hospital Pharmaceutical with HSS except: i) to the extent that the DHB Hospital may use its discretion to purchase a DV Pharmaceutical within the DV Limit, provided that (subject to subclause (iii) below) the DV Limit has not been exceeded nationally; ii) if the pharmaceutical supplier fails to supply that Hospital Pharmaceutical, in which case the relevant DHB Hospital does not have to comply with the DV Limit for that Hospital Pharmaceutical during that period of non-supply (and any such month(s) included in a period of non-supply will be excluded in any review of the DV Limit in accordance with clause 4.3 below); iii) that where the DV Limit has been exceeded nationally, the DHB Hospital may negotiate with the pharmaceutical supplier who supplies the National Contract Pharmaceutical with HSS for written permission to vary the application of that DHB Hospital’s Individual DV Limit for any patient whose exceptional needs require a DV Pharmaceutical. 4.3 PHARMAC may, in its discretion, for any period or part period: a) review usage by DHB Hospitals of the National Contract Pharmaceutical and DV Pharmaceuticals to determine whether the DV Limit has been exceeded; and b) audit compliance by DHBs with the DV Limits and related requirements. 4.4 PHARMAC will address any issues of non-compliance by any individual DHB with a DV Limit by: a) obtaining the relevant DHB’s assurance that it will comply with the DV Limit for that National Contract Pharmaceutical with HSS in the remainder of the applicable period and any subsequent periods; and b) informing the relevant supplier of the HSS Pharmaceutical of any individual DHB’s non-compliance with the DV Limit for that HSS Pharmaceutical. 4.5 In addition to the steps taken by PHARMAC under clause 4.4 above to address any issues of non-compliance by any individual DHB with a DV Limit, the relevant pharmaceutical supplier may require, in its discretion, financial compensation from the relevant DHB a) an amount representing its contribution towards exceeding the DV Limit (where PHARMAC is able to quantify this based on the information available to it); or b) the sum of $1,000 or $5,000 (depending on the terms of the applicable national contract applying to the HSS Pharmaceutical), whichever is the greater as between sub-paragraphs (a) and (b) within the number of business days specified in the notice requiring such payment to be made.

4.6 The relevant DV Pharmaceuticals for any National Contract Pharmaceutical with HSS are listed in Schedule H Part II of the Schedule alongside that National Contract Pharmaceutical with HSS and may be amended from time to time. For the purposes of assessing a DHB Hospital’s compliance with the DV Limit, if a Pharmaceutical has been added to be, or removed from being, a DV Pharmaceutical during the period that is being assessed PHARMAC is only to count the amount of those Pharmaceuticals that were purchased during the portion of the applicable period in which that Pharmaceutical was a DV Pharmaceutical.

5. Collection of rebates and payment of financial compensation

5.1 Following the receipt of any rebates from a pharmaceutical supplier in respect of a particular Hospital Pharmaceutical, PHARMAC will notify each relevant DHB and DHB Hospital of the amount of the rebate owing to it, being a portion of the total rebate determined by PHARMAC on the basis of that DHB Hospital’s usage of that Hospital Pharmaceutical, where this is able to be determined. Where data to determine individual DHB Hospitals’ usage is not available, PHARMAC will apportion rebates on the basis of an alternative method agreed between the relevant DHBs and PHARMAC. 5.2 PHARMAC will pay each DHB Hospital the rebate amounts (if any) owing to it, no less frequently than once each calendar quarter in respect of rebates received quarterly (or more often).

6. Price and Volume Data

6.1 DHB Hospitals are to provide to PHARMAC, on a monthly basis in accordance with PHARMAC’s requirements, any volume data and, unless it would result in a breach of an existing contract, price data held by those DHB Hospitals in respect of any Hospital Pharmaceuticals listed in Section H of the Schedule. 6.2 All price and volume data provided to PHARMAC under clause 6.1 above should identify the relevant Hospital Pharmaceutical by using a Pharmacode or some other unique numerical identifier, and the date (month and year) on which the DHB Hospital incurred a cost for the purchase of that Pharmaceutical. Volume is to be measured in units (that being the smallest possible whole unit – e.g. a capsule, a vial, a millilitre etc).

7. Assessed Pharmaceuticals

7.1 Assessed Pharmaceuticals are hereby deemed to include every medicine, therapeutic medical device, or related product or related thing listed in Section H Part III of the Schedule. 7.2 Any DHB Hospital or pharmaceutical supplier may apply to PHARMAC at any time to have a pharmaceutical assessed and to be placed on the Assessed Pharmaceutical list in Section H Part III of the Schedule.

8. Discretionary Community Supply Pharmaceuticals

8.1 Discretionary Community Supply Pharmaceuticals are deemed to include every medicine, therapeutic medical device, or related product or related thing listed in Section H Part IV of the Schedule. 8.2 PHARMAC may, in its discretion, list any pharmaceutical that is not a Community Pharmaceutical as a Discretionary Community Supply Pharmaceutical, including a pharmaceutical that PHARMAC is made aware of by HPAC, the Exceptional Circumstances Panel, a DHB Hospital or relevant hospital personnel. 8.3 A DHB Hospital may use its discretion to purchase Discretionary Community Supply Pharmaceuticals for use in the community, provided that, if the patient being treated with a Discretionary Community Supply Pharmaceutical usually resides in a district other than that within the jurisdiction of the DHB initiating the treatment, then the DHB initiating the treatment must either agree to fund any on-going treatment required once the patient has returned to his/her usual DHB, or obtain written consent from the DHB or DHBs in which the patient will reside following the commencement of treatment. 8.4 The funding of a Discretionary Community Supply Pharmaceutical for use in the community will be sourced from the relevant DHB’s own budget. For the avoidance of doubt, the Discretionary Community Supply Pharmaceutical is not a Community Pharmaceutical and funding is not available for Discretionary Community Supply Pharmaceuticals from the Pharmaceutical Budget. 8.5 Subject to rule 8.6, DHB Hospitals must not fund for use in the community, any pharmaceuticals that are not Discretionary Community Supply Pharmaceuticals unless they have been approved under Hospital Exceptional Circumstances.

8.6 DHB Hospitals may fund from their own budgets, any Pharmaceutical that is listed in Sections A-G of the Pharmaceutical Schedule without Hospital Exceptional Circumstances (HEC) approval provided that: (a) the condition for which that Pharmaceutical is supplied is consistent with any restrictions applying to that Pharmaceutical in Section A-G of the Pharmaceutical Schedule; and (b) the quantity supplied does not exceed that sufficient for up to 5 days treatment, or one original pack, where inappropriate to provide less.

9. Pharmaceutical Cancer Treatments

9.1 DHBs are obliged to fund Pharmaceutical Cancer Treatments in accordance with the October 2001 direction from the Minister of Health. 9.2 The list of Pharmaceutical Cancer Treatments may be amended from time to time. Additions and/or amendments to the list require the approval of the PHARMAC Board. 9.3 Pharmaceutical Cancer Treatments may be used in combination with each other, including where such combinations result in admixtures or dilutions that differ from those specified. 9.4 DHBs must not fund Pharmaceuticals for the treatment of cancer or Pharmaceutical Cancer Treatments for indications related to the treatment of cancer, if they are not listed in Sections A to G of the Pharmaceutical Schedule, unless the unlisted pharmaceutical: (a) has Cancer Exceptional Circumstances approval; or (b) has Community Exceptional Circumstances or Hospital Exceptional Circumstances approval; or (c) is being used as part of a bona fide clinical trial which has Ethics Committee approval; or (d) is being used and funded as part of a paediatric oncology service; or (e) was being used to treat the patient in question prior to 1 July 2005. 9.5 Some indications for Pharmaceutical Cancer Treatments listed in the Schedule are Unapproved Indications. Some of these formed part of the October 2001 direction from the Minister of Health as to pharmaceuticals and indications for which DHBs must provide funding. As far as reasonably practicable, these Unapproved Indications are marked in the Schedule. However, PHARMAC makes no representation and gives no guarantee as to the accuracy of this information. Practitioners prescribing Pharmaceutical Cancer Treatments for such Unapproved Indications should: (a) be aware of and comply with their obligations under sections 25 and 29 of the Medicines Act 1981, as applicable, and otherwise under that Act and the Medicines Regulations 1984; (b) be aware of and comply with their obligations under the Health and Disability Commissioner’s Code of Consumer Rights, including the requirement to obtain informed consent from the patient (PHARMAC recommends that Practitioners obtain written consent); and (c) exercise their own skill, judgment, expertise and discretion, and make their own prescribing decisions with respect to the use of an unapproved Pharmaceutical Cancer Treatment or a Pharmaceutical Cancer Treatment for an Unapproved Indication. 9.6 Applications to add pharmaceuticals, and add or amend indications for Pharmaceutical Cancer Treatments, may be made in writing by pharmaceutical suppliers and/or clinicians to PHARMAC. Applications should follow PHARMAC’s Guidelines for Submissions to PTAC for New Chemical Entity Pharmaceuticals and Recommended methods to derive clinical inputs for proposals to PHARMAC, copies of which are available from PHARMAC or PHARMAC’s website. 9.7 Applications made under clause 9.6 must be assessed by HPAC, PHARMAC, PTAC and/or relevant subcommittees of PTAC.

10. Practitioners prescribing unapproved Pharmaceuticals

Practitioners should, where possible, prescribe Pharmaceuticals that are approved under the Medicines Act 1981. However, the access criteria under which a Pharmaceutical is listed on the Pharmaceutical Schedule may: (a) in some case, explicitly permit Government funded access to a Pharmaceutical that is not approved under the Medicines Act 1981 or for an Unapproved Indication; or (b) not explicitly preclude Government funded access to a Pharmaceutical when it is used for an Unapproved Indication. Accordingly, if Practitioners are planning on prescribing an unapproved Pharmaceutical or a Pharmaceutical for an Unapproved Indication, Practitioners should: 15

(a) be aware of and comply with their obligations under sections 25 and 29 of the Medicines Act 1981, as applicable, and otherwise under that Act and the Medicines Regulations 1984; (b) be aware of and comply with their obligations under the Health and Disability Commissioner’s Code of Consumer Rights, including the requirement to obtain informed consent from the patient (PHARMAC recommends that Practitioners obtain written consent); and (c) exercise their own skill, judgment, expertise and discretion, and make their own prescribing decisions with respect to the use of an unapproved Pharmaceutical or a Pharmaceutical for an Unapproved Indication. Practitioners should be aware that simply by listing a Pharmaceutical on the Pharmaceutical Schedule PHARMAC makes no representations about whether that Pharmaceutical has any form of approval or consent under, or whether the supply or use of the Pharmaceutical otherwise complies with, the Medicines Act 1981. Further, the Pharmaceutical Schedule does not constitute an advertisement, advertising material or a medical advertisement as defined in the Medicines Act or otherwise.

Part II

Hospital Supply Status Products – cumulative to March 2009

Generic Name

Acetazolamide Aciclovir

Presentation

Tab 250 mg Tab dispersible 200 mg Tab dispersible 400 mg Tab dispersible 800 mg Tab 100 mg Tab 300 mg Inj 0.5 mg per ml, 1 ml Inj 5 mg per ml, 5 ml Inj 250 mg per ml, 2 ml Cap 100 mg Tab 5 mg Tab 10 mg Inj 250 mg Inj 500 mg Inj 1 g Drops 100 mg per 1 ml Cap 250 mg & 500 mg Inj 10 mg per ml, 1 ml Cream Tab 50 mg & 100 mg Eye drops 1% Inj 600 µg, 1 ml Inj 1200 µg, 1 ml Tab 500 mg Metered aqueous nasal spray, 50 µg per dose Metered aqueous nasal spray, 100 µg per dose Inj 600 mg Scalp app 0.1% Tab 200 mg Tab long-acting 400 mg Tab 50 mg Tab 5 mg Eye drops 0.2% Inf 0.125%, 100 ml theatre pack Inf 0.125%, 200 ml theatre pack Inf 0.25%, 100 ml theatre pack Inf 0.375%, 20 ml theatre pack Inj 0.5%, 4 ml Inj 0.5%, 8% glucose, 4 ml Inj 0.25%, 20 ml Inj 0.5%, 10 ml theatre pack Inj 0.5%, 10 ml Inj 0.5%, 20 ml

Brand Name

Diamox Lovir Lovir Lovir Apo-Allopurinol Apo-Allopurinol Prostin VR Biomed Amikin Symmetrel Apo-Amlodipine Ibiamox Ibiamox Ibiamox Ospamox Apo-Amoxi Mayne Multichem Pacific Atenolol Atropt AstraZeneca AstraZeneca Arrow-Azithromycin Alanase Alanase Sandoz Beta Scalp Fibalip Bezalip Retard Bicalox Lax-Tabs AFT Marcain Marcain Marcain Marcain Marcain Isobaric Marcain Heavy Marcain Marcain Marcain Marcain

Expiry Date*

2011 2009

Allopurinol Alprostadil Amikacin sulphate Amantadine hydrochloride Amlodipine Amoxycillin

2011 2009 2009 2011 2011 2011

Apomorphine hydrochloride Aqueous Atenolol Atropine sulphate

2010 2009 2011 2009 2011 2009 2009 2009

Azithromycin Beclomethasone dipropionate

Benzylpenicillin sodium (Penicillin G) Betamethasone valerate Bezafibrate Bicalutamide Bisacodyl Brimodine tartarate Bupivacaine hydrochloride

2011 2009 2011 2009 2011 2010 2011 2010

2009

*Expiry date of the Hospital Supply Status period is 30 June of the year indicated.

Hospital Supply Status Products – cumulative to March 2009

Generic Name

Bupivicaine hydrochloride with fentanyl

Presentation

Inj 0.125% with 2 µg fentanyl per ml, 15 ml Inj 0.125% with 2 µg fentanyl per ml, 20 ml Inj 0.125% with 2 µg fentanyl per ml, 100 ml Inj 0.125% with 2 µg fentanyl per ml, 200 ml Inj 10 mg per ml, 2.5 ml Oral liq 10 mg per ml Inj 100 iu per ml, 1 ml Cap 0.25 µg & 0.5 µg Tab eff 1 g Inj 50 mg, 100 mg, 300 mg & 1 g Tab 12.5 mg, 25 mg & 50 mg Inj 10 mg per ml, 5 ml, 15 ml & 45 ml Cap 250 mg Grans for oral liq 125 mg per 5 ml Inj 500 mg & 1 g Inj 500 mg Inj 1 g Inj 2 g Inj 500 mg, 1 g & 2 g Inj 750 mg & 1 mg Tab 10 mg Oral liq 1 mg per 1 ml Eye drops 0.5% Eye oint 1% Crm 1% obstetric Tab 25 mg Tab 250 mg Tab 500 mg Tab 750 mg Inj 2 mg per ml, 100 ml Tab 20 mg Grans for oral liq 125 mg per 5 ml Tab 250 mg Crm 0.05% Tab 500 µg Tab 2 mg Inj 500 u Crm 1% Vaginal crm 1% with applicator(s) Vaginal crm 2% with applicator(s) Soln 4%, 2 ml Tab 15 mg, 30 mg & 60 mg

Brand Name

Biomed Biomed Bupafen Bupafen Biomed Biomed Miacalcic Calcitriol-AFT Calsource Calcium Folinate Ebewe Apo-Captopril Carboplatin Ebewe Ranbaxy-Cefaclor Ranbaxy-Cefaclor Hospira Cefotaxime Sandoz Cefotaxime Sandoz Cefotaxime Sandoz Fortum Zinacef Zetop Cetirizine-AFT Chlorsig Chlorsig Orion Hygroton Rex Medical Rex Medical Rex Medical Aspen Ciprofloxacin Arrow-Citalopram Klacid Klamycin Dermol Paxam Paxam Dysport Clomazol Clomazol Clomazol Biomed PSM

Expiry Date*

2011

Caffeine citrate Calcitonin Calcitriol Calcium Calcium folinate Captopril Carboplatin Cefaclor monohydrate Cefazolin sodium Cefotaxime

2009 2011 2009 2011 2011 2010 2009 2010 2011 2011

Ceftazidime Cefuroxime sodium Cetirizine Chloramphenicol Chlorhexidine Chlorthalidone Ciprofloxacin

2011 2011 2011 2009 2009 2009 2011

Citalopram hydrobromide Clarithromycin Clobetasol propionate Clonazepam Clostridum botulinum Clotrimazole

2009 2011 2010 2009 2011 2009 2011 2010 2009 2010

Cocaine Codeine phosphate

18*Expiry date of the Hospital Supply Status period is 30 June of the year indicated.

Hospital Supply Status Products – cumulative to March 2009

Generic Name

Colchicine Colistin sulphomethate Co-Trimoxazole Cyclizine hydrochloride Cyclophosphamide Cyproterone acetate Dacarbazine Daclizumab Dalteparin sodium

Presentation

Tab 500 µg Inj 150 mg Tab trimethoprim 80 mg and sulphamethoxazole 400 mg Tab 50 mg Tab 50 mg Tab 50 mg Inj 200 mg Inj 25 mg per 5 ml vial Inj 2,500 iu per 0.2 ml prefilled syringe Inj 5,000 iu per 0.2 ml prefilled syringe Inj 7,500 iu per 0.75 ml graduated syringe Inj 10,000 iu per 1 ml graduated syringe Inj 12,500 iu per 0.5 ml prefilled syringe Inj 15,000 iu per 0.6 ml prefilled syringe Inj 18,000 iu per 0.72 ml prefilled syringe Cap 25 mg & 50 mg Inj 1 mg per ml, 20 ml Inj 500 mg Nasal spray 10 µg per dose Inj 4 mg per ml, 1 ml & 2 ml Tab 5 mg Inj 50%, 10 ml Inj 50%, 90 ml Eye drops 1 mg per ml Inj 25 mg per ml, 3 ml Suppos 12.5 mg, 25 mg, 50 mg & 100 mg Gel 1 mg and 2 mg Tab long-acting 150 mg Tab 50 mg with total sennosides 8 mg Inj 40 mg per ml, 5 ml Tab 2 mg & 4 mg Inj 10 mg, 50 mg, 100 mg & 200 mg Ointment BP 100 g & 500 g Inj 30 mg per ml, 1 ml Inj 2 mg per ml, 5 ml, 25 ml, 50 ml & 100 ml Inj 500 µg per ml, 1 ml Grans for oral liq 200 mg per 5 ml Grans for oral liq 400 mg per 5 ml

Brand Name

Colgout Colistin-Link Trisul Nausicalm Cycloblastin Siterone Mayne Zenapax Fragmin Fragmin Fragmin Fragmin Fragmin Fragmin Fragmin Dantrium Dantrium IV Mayne Desmopressin PH&T Mayne PSM Biomed Biomed Voltaren Ophtha Voltaren Voltaren Prostin E2 Pytazen SR Laxsol Mayne Apo-Doxazosin Doxorubicin Ebewe AFT Mayne Epirubicin Ebewe Mayne E-Mycin E-Mycin

Expiry Date*

2010 2010 2011 2009 2010 2009 2009 2009 2009

Dantrolene sodium Desferrioxamine mesylate Desmopressin Dexamethasone sodium phosphate Dexamphetamine sulphate Dextrose Diclofenac sodium

2009 2010 2011 2009 2010 2011 2009 2011

Dinoprostone Dipyridamole Docusate sodium with sennosides Dopamine hydrochloride Doxazosin mesylate Doxorubicin Emulsifying Ointment Ephedrine sulphate Epirubicin Ergometrine maleate Erythromycin ethyl succinate

2009 2011 2009 2009 2010 2009 2011 2009 2009 2009 2011

*Expiry date of the Hospital Supply Status period is 30 June of the year indicated.

Hospital Supply Status Products – cumulative to March 2009

Generic Name

Erythropoietin beta

Presentation

Inj 1,000 iu prefilled syringe Inj 2,000 iu prefilled syringe Inj 3,000 iu prefilled syringe Inj 4,000 iu prefilled syringe Inj 5,000 iu prefilled syringe Inj 6,000 iu prefilled syringe Inj 10,000 iu prefilled syringe Cap 50 mg & 100 mg Oral liq 150 mg per 5 ml Tab 5 mg Grans for oral liq 125 mg per 5 ml Grans for oral liq 250 mg per 5 ml Inj 250 mg Inj 500 mg Inj 1 g Cap 250 mg & 500 mg Cap 50 mg Cap 150 mg Cap 200 mg Oral liq 10 mg per ml Inj 2 mg per ml, 50 ml Tab 10 mg Tab inj 50 mg Oint 950 µg, with fluocortolone pivalate 920 µg, and cinchocaine hydrochloride 5 mg per g Suppos 630 µg, with fluocortolone pivalate 610 µg, and cinchocaine hydrochloride 1 mg Eye drops 0.1% Inj 25 mg per ml, 100 ml Inj 50 mg per ml, 10 ml Inj 50 mg per ml, 20 ml Inj 50 mg per ml, 50 ml Inj 50 mg per ml, 100 ml Cap 20 mg Tab disp 20 mg, scored Crm 2% & Oint 2% Inj 40 mg per ml, 2 ml Tab 80 mg Tab 5 mg

Brand Name

New-Recormon New-Recormon New-Recormon New-Recormon New-Recormon New-Recormon New-Recormon Vepesid Ferodan Fintral AFT AFT Flucloxin

Expiry Date*

2009

Etoposide Ferrous sulphate Finasteride Flucloxacillin Flucloxacillin sodium

2009 2010 2011 2009 2011

Fluconazole

Fludarabine Fludarabine Phosphate Fluocortolone caproate with fluocortolone pivalate and cinchocaine

Staphlex Pacific Pacific Pacific Diflucan POS m-Fluconazole Fludara Fludara Ultraproct

2009 2011

2009 2011 2011 2010

Ultraproct

Fluorometholone Fluorouracil sodium

Fluoxetine hydrochloride Fusidic acid Gentamicin sulphate Gliclazide Glipizide

Flucon Mayne Fluorouracil Ebewe Fluorouracil Ebewe Fluorouracil Ebewe Fluorouracil Ebewe Fluox Fluox Foban Pfizer Apo-Gliclazide Minidiab

2009 2010

2010 2010 2009 2011 2011

20*Expiry date of the Hospital Supply Status period is 30 June of the year indicated.

Hospital Supply Status Products – cumulative to March 2009

Generic Name

Glyceryl trinitrate

Presentation

Tab 600 µg TDDS 5 mg TDDS 10 mg Spray 400 µg per dose Inj 1 mg per ml, 5 ml Inj 1 mg per ml, 50 ml Inj 5 mg per ml, 10 ml Inj 10 iu per ml, 5 ml Inj 1,000 iu per ml, 1 ml Inj 20 mg per ml, 1 ml Crm 1% Tab 5 mg & 20 mg Rectal foam 10%, CFC-Free Inj 20 mg per ml, 1 ml Tab 10 mg Eye drops 0.5% Oral liq 100 mg per 5 ml Cap 5 mg & 10 mg Inj 5 mg & 10 mg Tab 10 mg & 25 mg Tab 2.5 mg Inj 270 mg per ml (iodine equivalent), 50 ml Inj 270 mg per ml (iodine equivalent), 100 ml Inj 320 mg per ml (iodine equivalent), 50 ml Inj 320 mg per ml (iodine equivalent), 100 ml Inj 320 mg per ml (iodine equivalent), 200 ml

Brand Name

Lycinate Nitroderm TTS 5 Nitroderm TTS 10 Nitrolingual Pumpspray Nitronal Nitronal Mayne AstraZeneca Mayne Apresoline PSM Douglas Colifoam Buscopan Gastrosoothe Methopt Fenpaed Zavedos Zavedos Tofranil Napamide Visipaque Visipaque Visipaque Visipaque Visipaque

Expiry Date*

2011

2009

Heparinised saline Heparin sodium Hydralazine Hydrocortisone Hydrocortisone acetate Hyoscine N-Butylbromide Hypromellose Ibuprofen Idarubicin hydrochloride Imipramine hydrochloride Indapamide Iodixanol

2009 2009 2009 2011 2009 2009 2011 2011 2010 2009 2009 2009 2009

*Expiry date of the Hospital Supply Status period is 30 June of the year indicated.

Hospital Supply Status Products – cumulative to March 2009

Generic Name

Iohexol

Presentation

Inj 240 mg per ml (iodine equivalent), 50 ml Inj 300 mg per ml (iodine equivalent), 20 ml Inj 300 mg per ml (iodine equivalent), 50 ml Inj 300 mg per ml (iodine equivalent), 100 ml Inj 300 mg per ml (iodine equivalent), 500 ml Inj 350 mg per ml (iodine equivalent), 20 ml Inj 350 mg per ml (iodine equivalent), 50 ml Inj 350 mg per ml (iodine equivalent), 75 ml Inj 350 mg per ml (iodine equivalent), 100 ml Inj 350 mg per ml (iodine equivalent), 200 ml Inj 350 mg per ml (iodine equivalent), 500 ml Nebuliser soln 250 µg per ml, 1 ml Nebuliser soln 250 µg per ml, 2 ml Inj 20 mg per ml, 2 ml & 5 ml Inj 50 mg per ml, 2 ml Liq 250 ml bottle Tab long-acting 60 mg Cap 10 mg Cap 20 mg Cap 100 mg Tab 3 mg Shampoo 2% Oral liq 10 g per 15 ml Eye drops 0.25% & 0.5% Cap 50 mg with benserazide 12.5 mg Tab dispersible 50 mg with benserazide 12.5 mg Cap 100 mg with benserazide 25 mg Cap long-acting 100 mg with benserazide 25 mg Cap 200 mg with benserazide 50 mg Gel 2% Inj 0.5%, 5 ml Pump spray 10%, 50 ml CFC-free Inj 1%, 2 ml, 5 ml & 20 ml Inj 2%, 2 ml, 5 ml & 20 ml

Brand Name

Omnipaque Omnipaque Omnipaque Omnipaque Omnipaque Omnipaque Omnipaque Omnipaque Omnipaque Omnipaque Omnipaque Ipratropium Steri-Neb Ipratropium Steri-Neb Camptosar Ferrum H Abbott Forane Duride Isotane 10 Isotane 20 Sporanox Stromectol Sebizole Duphalac Betagan Madopar 62.5 Madopar Dispersible Madopar 125 Madopar HBS Madopar 250 Orion Xylocaine Xylocaine Xylocaine Xylocaine

Expiry Date*

2009

Ipratropium bromide Irinotecan Iron Polymaltose Isoflurane Isosorbide mononitrate Isotretinoin Itraconazole Ivermectin Ketoconazole Lactulose Levobunolol Levodopa with benserazide

2010 2009 2011 2009 2009 2009 2010 2011 2011 2010 2010 2009

Lignocaine Lignocaine hydrochloride

2009 2010 2009

22*Expiry date of the Hospital Supply Status period is 30 June of the year indicated.

Hospital Supply Status Products – cumulative to March 2009

Generic Name

Lignocaine hydrochloride with adrenaline

Presentation

Inj 1% with 1:100,000 of adrenaline, 5 ml Inj 1% with 1:200,000 of adrenaline, 20 ml Inj 2% with 1:200,000 of adrenaline 20 ml Gel 2% with 0.05% chlorhexidine Crm 2.5% with prilocaine 2.5%, 5 g Crm 2.5% with prilocaine 2.5%, 30 g Inj 50 mg vial Oral liq 1 mg per ml Tab 10 mg Tab 1 mg & 2.5 mg Inj 49.3%, 5 ml Tab 135 mg Tab 2.5 mg, 5 mg, 10 mg, 100 mg & 200 mg Oral soln 660 mg per ml with sodium amidotrizoate 100 mg per ml, 100 ml Inj 469 mg per ml (equivalent to 0.5 mmol per ml), 10 ml prefilled syringe Inj 469 mg per ml (equivalent to 0.5 mmol per ml), 20 ml Inj 500 mg & 1 g Enema 1 g per 100 ml Inj 100 mg per ml, 4 ml Inj 100 mg per ml, 10 ml Tab 500 mg & 850 mg Tab 5 mg Inj 100 mg per ml, 10 ml Inj 100 mg per ml, 50 ml Tab 2.5 mg & 10 mg Tab 125 mg Tab 250 mg Tab 500 mg Tab 5 mg, 10 mg & 20 mg Tab long-acting 20 mg Tab 4 mg & 100 mg Crm 0.1% & Oint 0.1% Inj 40 mg per ml, 1 ml Inj 40 mg per ml with lignocaine Inj 40 mg per ml, 1 ml Inj 62.5 mg per ml, 1 ml Inj 5 mg per ml, 2 ml Tab long-acting 200 mg

Brand Name

Xylocaine Xylocaine Xylocaine

Expiry Date*

2010

Lignocaine with chlorhexidine Lignocaine with prilocaine Liposomal amphotericin Loratadine Lorazepam Magnesium sulphate Mebeverine hydrochloride Medroxyprogesterone acetate Meglumine diatrizoate with sodium amidotrizoate Meglumine gadopentetate

Pfizer EMLA EMLA AmBisome Lorapaed Loraclear Hayfever Relief Ativan Mayne Colofac Provera Gastrografin Magnevist Magnevist Merrem Pentasa Uromitexan Uromitexan Arrow-Metformin Methatabs Methotrexate Ebewe

2009 2010 2009 2010 2009 2009 2011 2010 2009 2009

Meropenem Mesalazine Mesna Metformin hydrochloride Methadone hydrochloride Methotrexate

2011 2009 2010 2009 2010 2011

Methyldopa

Methylphenidate hydrochloride Methylprednisolone Methylprednisolone aceponate Methylprednisolone acetate Methylprednisolone acetate with lidocaine Methylprednisolone sodium succinate Metoclopramide hydrochloride Metoprolol tartrate

Methoblastin 2009 Prodopa 2011 Prodopa Prodopa Rubifen 2009 Rubifen SR Medrol 2009 Advantan 2009 Depo Medrol 2011 Depo Medrol with Lidocaine 2011 Solu-Medrol Solu-Medrol Pfizer Slow-Lopresor 2009 2011 2009 23

*Expiry date of the Hospital Supply Status period is 30 June of the year indicated.

Hospital Supply Status Products – cumulative to March 2009

Generic Name

Metronidazole Miconazole nitrate Midazolam Mitozantrone Morphine hydrochloride

Presentation

Inj 500 mg, 100 ml Crm 2% Inj 1 mg per ml, 5 ml Inj 5 mg per ml, 3 ml Inj 2 mg per ml, 5 ml & 10 ml Oral liq 1 mg per ml Oral liq 2 mg per ml Oral liq 5 mg per ml Oral liq 10 mg per ml Inj 1 mg per ml, 10 ml prefilled syringe Inj 1 mg per ml, 30 ml prefilled syringe Inj 1 mg per ml, 50 ml prefilled syringe Inj 2 mg per ml, 30 ml prefilled syringe Inj 10 mg per ml, 1 ml Inj 30 mg per ml, 1 ml Cap long-acting 10 mg, 30 mg, 60 mg, 100 mg and 200 mg Tab immediate release 10 mg & 20 mg Inj 5 mg per ml, 1 ml Inj 15 mg per ml, 1 ml Inj 80 mg per ml, 5 ml Tab 40 mg & 80 mg Tab 50 mg Tab 275 mg Inj 2.5 mg per ml, 1 ml Oral suspension 10 mg per ml Gum 2 mg (mint & fruit) Gum 4 mg (mint & fruit) Tab long-acting 20 mg Tab 5 mg Tab 10 mg Tab 25 mg Oral liq 1000,000 u per ml Cap 500,000 u Tab 500,000 u Tab 4 mg & 8 mg Tab disp 4 mg & 8 mg Oral liq 5 mg per 5 ml Tab 5 mg Inj 10 mg per ml, 1 ml Inj 10 mg per ml, 2 ml Oral liq 5 mg per 5 ml Inj 5 iu per ml, 1 ml Inj 10 iu per ml, 1 ml Inj 5 iu with ergometrine maleate 500 µg per ml, 1 ml

Brand Name

AFT Multichem Hypnovel Hypnovel Mitozantrone Ebewe RA-Morph RA-Morph RA-Morph RA-Morph Biomed Biomed Biomed Biomed Mayne Mayne m-Eslon Sevredol Mayne Mayne Mayne Apo-Nadolol ReVia Sonaflam AstraZeneca Viramune Suspension Habitrol Nyefax Retard Primolut N Norpress Norpress Nilstat Nilstat Nilstat Zofran Zofran Zydis Apo-Oxybutynin Apo-Oxybutynin OxyNorm OxyNorm OxyNorm Syntocinon Syntocinon Syntometrine

Expiry Date*

2011 2011 2009 2010 2009

Morphine sulphate

2011

2009 2009 2009 2009 2010 2010 2010 2010 2009 2010 2009 2011 2011 2011 2010 2010 2010 2010

Morphine tartrate Nadolol Naltrexone hydrochloride Naproxen sodium Neostigmine methlysulphate Nevirapine Nicotine Nifedipine Norethisterone Nortriptyline Nystatin

Ondansetron hydrochloride Oxybutynin Oxycodone hydrochloride

Oxytocin Oxytocin with ergometrine maleate

2009 2009

24*Expiry date of the Hospital Supply Status period is 30 June of the year indicated.

Hospital Supply Status Products – cumulative to March 2009

Generic Name

Paclitaxel

Presentation

Inj 30 mg Inj 100 mg Inj 150 mg Inj 300 mg Inj 600 mg Inj 3 mg per ml, 5 ml & 10 ml Inj 6 mg per ml, 10 ml Inj 9 mg per ml, 10 ml Inj 2 mg per ml, 2 ml Tab 20 mg & 40 mg Oral liq 120 mg per 5 ml Oral liq 250 mg per 5 ml Suppos 25 mg & 50 mg Tab 20 mg Inf 10%, 500 ml bag Inf 6%, 500 ml bag Tab 1 mg Tab 100 mg Cap potassium salt 250 mg & 500 mg Grans for oral liq 125 mg per 5 ml Grans for oral liq 250 mg per 5 ml Oral drops 10% Tab long-acting 600 mg Tab 1 mg, 2 mg & 5 mg Tab 1 mg Tab 2.5 mg Tab 5 mg Tab 20 mg Inj 0.5%, 50 ml Inj 2%, 5 ml Inj 1.5 mega u Tab 10 mg & 25 mg Inj 1%, 20 ml Inj 1%, 50 ml Inj 1%, 100 ml Inj 1%, 50 ml prefilled syringe Inj 2%, 50 ml prefilled syringe Tab 200 mg Tab 300 mg Oral liq 150 mg per 10 ml Inj 10 iu vial Cap 150 mg Inj 100 mg per 10 ml vial Inj 500 mg per 50 ml vial

Brand Name

Expiry Date*

2011

Pamidronate disodium

Pancuronium bromide Pantoprazole Paracetamol

Paroxetine hydrochloride Pentastarch plasma expander Pergolide Perhexiline maleate Phenoxymethylpenicillin (Penicillin V) Poloxamer Potassium chloride Prazosin hydrochloride Prednisone

Prilocaine hydrochloride Procaine penicillin Promethazine hydrochloride Propofol

Quinine sulphate Ranitidine hydrochloride Reteplase Rifabutin Rituximab

Paclitaxel Ebewe Paclitaxel Ebewe Paclitaxel Ebewe Paclitaxel Ebewe Paclitaxel Ebewe Pamisol Pamisol Pamisol AstraZeneca Dr Reddy’s Pantoprazole Paracare Junior Paracare Adult Biomed Loxamine StarQuin 10% StarQuin 200 6% Permax Pexsig Cilicaine VK AFT AFT Coloxyl Span-K Apo-Prazo Apo-Prednisone Apo-Prednisone Apo-Prednisone Apo-Prednisone Citanest Citanest Cilicaine Allersoothe Diprivan Diprivan Diprivan Diprivan Diprivan Q 200 Q 300 Peptisoothe Rapilysin Mycobutin Mabthera Mabthera

2011

2009 2010 2011 2009 2010 2011 2009 2011 2009 2010

2011 2009 2010 2011

2010 2011 2011 2009

2009 2010 2009 2010 2009

*Expiry date of the Hospital Supply Status period is 30 June of the year indicated.

Hospital Supply Status Products – cumulative to March 2009

Generic Name

Ropivicaine hydrochloride

Presentation

Inj 2 mg per ml, 10 ml Inj 2 mg per ml, 20 ml Inf 2 mg per ml, 100 ml Inf 2 mg per ml, 200 ml Inj 7.5 mg per ml, 10 ml Inj 7.5 mg per ml, 20 ml Inj 10 mg per ml, 10 ml Inj 10 mg per ml, 20 ml Inf 2 mg per ml with 2 µg of fentanyl per ml, 100 ml Inf 2 mg per ml with 2 µg of fentanyl per ml, 200 ml Tab 150 mg & 300 mg Oral liq 2 mg per 5 ml Nebuliser soln, 1 mg per ml, 2.5 ml Nebuliser soln, 2 mg per ml, 2.5 ml Liq 250 ml bottle Soln 0.9% for irrigation Inj 0.9% per 5 ml & 10 ml Inj 23.4%, 20 ml Grans eff 4 g sachets Inj 10 mg per ml, 0.35 ml; and inj 30 mg per ml with chondroitin sulphate 40 mg per ml, 0.4 ml Inj 10 mg per ml, 0.5 ml; and inj 30 mg per ml with chondroitin sulphate 40 mg per ml, 0.55 ml Opthalmic inj 14 mg per ml Opthalmic soln 10 mg per ml Inj 250,000 iu Inj 1,5000,000 iu Inj 50 mg per ml, 2 ml Liq Soln 2.3% with triethanolamine lauryl sulphate and fluorescein sodium Tab 10 mg Tab 250 mg Inj 1 mg Inj 100 mg per ml, 10 ml Inj 250 µg Inj 1 mg per ml, 1 ml Eye drops 0.25% & 0.5% Inj 100 mg per ml, 5 ml Crm 0.02% Oint 0.02% Inj 40 mg per ml, 1 ml 0.1% in dental paste

Brand Name

Naropin Naropin Naropin Naropin Naropin Naropin Naropin Naropin Naropin Naropin Arrow-Roxithromycin Salapin Asthalin Asthalin Abbott Sevorane Pfizer AstraZeneca Biomed Ural Duovisc Duovisc Healon GV Healon Clear Streptase Streptase AstraZeneca Midwest Pinetarsol Normison Apo-Terbinafine Glypressin Depo-Testosterone Synachten Synachten Depot Apo-Timop Cyklokapron Aristocort Aristocort Kenacort-A 40 Kenalog in Orabase

Expiry Date*

2010

Ropivicaine hydrochloride with fentanyl

2010

Roxithromycin Salbutamol

2009 2010 2009 2009 2011 2009 2009 2010 2009

Sevoflurane Sodium chloride

Sodium citro-tartrate Sodium hyaluronate

Streptokinase Suxamethonium chloride Syrup (pharmaceutical grade) Tar with triethanolamine lauryl sulphate and fluorescein Temazepam Terbinafine Terlipressin Testosterone cypionate Tetracosactrin Timolol maleate Tranexamic acid Triamcinolone acetonide

2011 2010 2010 2011 2011 2011 2011 2011 2011 2011 2009 2011

26*Expiry date of the Hospital Supply Status period is 30 June of the year indicated.

Hospital Supply Status Products – cumulative to March 2009

Generic Name

Triamcinolone acetonide with gramicidin, neomycin and nystatin Trimethoprim Tropisetron Ursodeoxycholic acid Vancomycin hydrochloride Vincristine sulphate Vinorelbine Water Zinc sulphate Zinc and castor oil Zopiclone

Presentation

Brand Name

Expiry Date*

2009

Ear drops 1 mg with nystatin 100,000 u, Kenacomb neomycin sulphate 2.5 mg and gramicidin 250 µg per g Tab 300 mg TMP Cap 5 mg Navoban Cap 300 mg Actigall Inj 50 mg per ml, 10 ml Pacific Inj 1 mg per ml, 1 ml & 2 ml Mayne Inj 10 mg per ml, 1 ml & 5 ml Vinorelbine Ebewe Purified for inj 5 ml, 10 ml & 20 ml Multichem Cap 220 mg Zincaps Oint Orion Tab 7.5 mg Apo-Zopiclone

2011 2009 2011 2011 2009 2009 2009 2011 2009 2011

*Expiry date of the Hospital Supply Status period is 30 June of the year indicated.

Part II - Pharmaceuticals Under National Contracts

Contracted Pharmaceutical Description Brand Price ($) Per (ex man. excl. GST) DV Limit DV Limit applies from DV Pharmaceuticals

ABACAVIR SULPHATE WITH LAMIVUDINE Tab 600 mg with lamivudine 300 mg ........ ABCIXIMAB Inj 10 mg.................................................. ACETAZOLAMIDE Tab 250 mg.............................................. ACICLOVIR Inj 25 mg per ml, 10 ml ............................ Tab dispersible 200 mg ............................

Kivexa ReoPro Diamox Mayne Lovir

630.00 579.53 10.40 28.72 1.98

30 1 100 5 25 1% Dec-08 (B)

Jun-07

Tab dispersible 400 mg ............................

Lovir

6.64

Jun-07

Tab dispersible 800 mg ............................

Lovir

7.38

Jun-07

Acicvir Alpha-Aciclovir Global Aciclovir Zovirax Acicvir Alpha-Aciclovir Global Aciclovir Zovirax Acicvir Alpha-Aciclovir Global Aciclovir Zovirax

ACTIVATED CHARCOAL Oral liq 50 g per 250 ml ............................ ADALIMUMAB Inj 40 mg per 0.8 ml prefilled syringe.................................... Inj 40 mg per 0.8 ml prefilled pen ......................................... ADEFOVIR DIPIVOXIL Tab 10 mg................................................ ADRENALINE Inj 1 in 1,000, 1 ml ................................... Inj 1 in 10,000, 10 ml ............................... ALENDRONATE SODIUM Tab 70 mg................................................

Carbosorb-X

37.75

250 ml

Humira HumiraPen Hepsera

1,799.92 1,799.92 670.00

2 2 30 5 5 5 4

Mayne 5.25 Aspen-Adrenaline 4.98 Mayne 27.00 Fosamax 35.91

ALENDRONATE SODIUM WITH CHOLECALCIFEROL Tab 70 mg with cholecalciferol 2,800 iu ............................................... Fosamax Plus ALFACALCIDOL Cap 0.25 µg ............................................. Cap 1 µg .................................................. One-Alpha One-Alpha

35.91 26.32 87.98

4 100 100

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 5.44 4.03 250 100

DV Limit

DV Limit applies from Mar-09 Mar-09

DV Pharmaceuticals

ALLOPURINOL Tab 100 mg ............................................. Tab 300 mg..............................................

Apo-Allopurinol Apo-Allopurinol

1% 1%

Allohexal Allorin Progout Allohexal Allorin Progout (B) (B) (B) (B)

ALPROSTADIL Inj 0.5 mg per ml, 1 ml ............................. AMANTADINE HYDROCHLORIDE Cap 100 mg ............................................. AMIKACIN SULPHATE Inj 5 mg per ml, 5 ml ................................ Inj 250 mg per ml, 2 ml ............................ AMILORIDE Oral liq 1 mg per ml .................................. AMILORIDE WITH HYDROCHLOROTHIAZIDE Tab 5 mg with hydrochlorothiazide 50 mg ................... AMINOPHYLLINE Inj 25 mg per ml, 10 ml ............................ AMISULPRIDE Tab 100 mg.............................................. Tab 200 mg.............................................. Tab 400 mg.............................................. Oral liquid 100 mg per ml ......................... AMITRIPTYLINE Tab 10 mg................................................ Tab 25 mg................................................ Tab 50 mg................................................ AMLODIPINE Tab 5 mg.................................................. Tab 10 mg................................................ AMOXYCILLIN Cap 250 mg ............................................. Cap 500 mg ............................................. Inj 250 mg................................................ Inj 500 mg................................................ Inj 1 g.......................................................

Prostin VR Symmetrel Biomed Amikin Biomed

1,417.50 47.81 88.00 15.00 26.20

5 60 10 1 25 ml

1% 1% 1% 1%

Dec-06 Oct-08 Nov-06 Sept-06

Amizide Mayne Solian Solian Solian Solian Amirol Amitrip Amitrip Apo-Amlodipine

13.00 12.84 22.52 97.03 185.44 55.44 2.77 3.40 5.20 7.33

500 5 30 60 60 60 ml 50 100 100 100 100 1% 1% Feb-09 Feb-09 Calvasc Norvasc Calvasc Norvasc Amoxil Moxlin Ospamox Amoxil Moxlin Ospamox (B) (B) (B)

Apo-Amlodipine 11.79

Apo-Amoxi Apo-Amoxi Ibiamox Ibiamox Ibiamox

17.30 27.25 12.42 14.24 21.62

500 500 10 10 10

1% 1% 1% 1% 1%

Sept-07 Sept-07 Jan-09 Jan-09 Jan-09

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST)

DV Limit

DV Limit applies from

DV Pharmaceuticals

AMOXYCILLIN CLAVULANATE Gran 125 mg with 31.25 mg clavulanic acid per 5 ml........................................ Gran 250 mg with 62.5 mg clavulanic acid per 5 ml........................................ Inj 600 mg, 500 mg with 100 mg clavulanic acid .................................... Inj 1.2 g, 1000 mg with 200 mg clavulanic acid ..................................... Tab amoxycillin 500 mg with potassium clavulanate 125 mg .............

Augmentin Augmentin Augmentin Augmentin

2.75 4.75 28.24 31.60

100 ml 100 ml 10 10 Augmentin

Synermox 25.10 100 1% May-09 Augmentin 6.40 20 Note – the Augmentin brand of amoxycillin clavulanate tablets will be delisted from 1 May 2009 ANASTROZOLE-DP Tab 1 mg.................................................. DP-Anastrozole 29.50 ATGAM Mayne AFT 2,137.50 50.43 1.49 30 5 5 100 g 1% 1% Oct-06 Nov-08

ANTITHYMOCYTE GLOBULIN (EQUINE) Inj 50 mg per ml, 5 ml .............................. APOMORPHINE HYDROCHLORIDE Inj 10 mg per ml, 1 ml .............................. AQUEOUS Cream ......................................................

(B) Orion Multichem PSM Adern 500 g Multichem 500 g Multichem 2,000 g Pharmacy Health

Note – DV limit applies to packsizes 100 g or less Cream ...................................................... AFT

2.28

500 g

Jan-09

DV limit applies to pack sizes of 500 g or greater ARIPIPRAZOLE Tab 10 mg................................................ Tab 15 mg................................................ Tab 20 mg................................................ Tab 30 mg................................................ ATAZANAVIR SULPHATE Cap 150 mg ............................................. Cap 200 mg ............................................. ATENOLOL Tab 50 mg................................................ Tab 100 mg.............................................. ATRACURIUM BESYLATE Inj 10 mg per ml, 2.5 ml ........................... Inj 10 mg per ml, 5 ml .............................. Abilify Abilify Abilify Abilify Reyataz Reyataz Pacific Atenolol 123.54 175.28 213.42 260.07 568.34 757.79 6.50 30 30 30 30 60 60 500 500 1% 1% Sept-06 Sept-06 Anselol Apo-Atenolol Global Atenolol Anselol Apo-Atenolol Global Atenolol

Pacific Atenolol 11.30

Mayne Tracrium Mayne Tracrium

12.55 20.65 32.55 38.50

5 5 5 5

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST)

DV Limit

DV Limit applies from

DV Pharmaceuticals

ATROPINE SULPHATE Eye drops 1% ........................................... Inj 600 µg, 1 ml........................................ Inj 1200 µg, 1 ml...................................... AZITHROMYCIN Tab 500 mg.............................................. BACLOFEN Tab 10 mg................................................ BASILIXIMAB Inj 20 mg amp .......................................... BECLOMETHASONE DIPROPIONATE Metered aqueous nasal spray, 50 µg per dose .................................... Metered aqueous nasal spray, 100 µg per dose .................................. BENZATHINE BENZYLPENICILLIN Inj 1.2 mega u per 2 ml............................. BENZYLPENICILLIN SODIUM Inj 1 mega u ............................................. BERACTANT Inj 25 mg per ml, 8 ml intratracheal........... BETAHISTINE DIHYDROCHLORIDE Tab 16 mg................................................ BETAMETHASONE VALERATE Scalp app 0.1% ........................................ BEZAFIBRATE Tab 200 mg.............................................. Tab long-acting 400 mg............................ BICALUTAMIDE Tab 50 mg................................................ BISACODYL Suppos 10 mg.......................................... Tab 5 mg.................................................. BLEOMYCIN SULPHATE Inj 15,000 iu .............................................

Atropt AstraZeneca AstraZeneca ArrowAzithromycin Pacifen Simulect

4.40 26.00 32.00 9.90

15 ml 50 50 2

1% 1% 1% 1%

Dec-08 Dec-06 Dec-06 Nov-07

(B) Pfizer (B) Zithromax

3.75 3,200.00

100 1

Alanase

2.35

200 1% doses 200 1% doses 10 10 1 84 100 ml 1% 90 30 30 1% 5% 1% 1%

Dec-06

Aldecin Atomase Beconase Atomase Beconase

Alanase

2.46

Dec-06

Bicillin LA Sandoz Survanta Vergo 16 Beta Scalp Fibalip Bezalip Retard Bicalox

200.00 10.49 550.00 7.56 5.25 9.75 7.60 27.10

Dec-08

Benpen

Dec-06 Dec-08 Apr-08 Jan-09

(B) (B) (B) Cosudex Rex Medical

Fleet Lax-Tabs

3.96 5.09

12 200

Sept-07

Apo-Bisacodyl Dulcolax

Blenoxane

680.00

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 7.93 5 ml

DV Limit

DV Limit applies from Sept-08

DV Pharmaceuticals

BRIMONIDINE TARTARATE Eye drops 0.2% ........................................ BUDESONIDE Metered aqueous nasal spray, 50 µg per dose .................................... Metered aqueous nasal spray, 100 µg per dose .................................. BUMETANIDE Tab 1 mg ................................................. BUPIVACAINE HYDROCHLORIDE Inf 0.125%, 100 ml theatre pack ............... Inf 0.125%, 200 ml theatre pack ............... Inf 0.25%, 100 ml theatre pack ................. Inj 0.25% per 20 ml .................................. Inj 0.375%, 20 ml theatre pack ................. Inj 0.5% per 10 ml theatre pack................. Inj 0.5% per 10 ml .................................... Inj 0.5% per 20 ml .................................... Inj 0.5%, 4 ml ........................................... Inj 0.5%, 8% glucose, 4 ml .......................

AFT

Alphagan

Butacort Aqueous Butacort Aqueous Burinex

2.95 3.30

200 doses 200 doses

16.36

100 5 5 5 5 5 5 50 5 5 5 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% Aug-07 Aug-07 Aug-07 Sept-06 Aug-07 Sept-06 Sept-06 Sept-06 Aug-07 Aug-07 (B) (B) (B) Pfizer (B) Pfizer Pfizer (B) (B) (B)

Marcain 109.39 Marcain 146.23 Marcain 132.42 Marcain 39.00 Marcain 56.20 Marcain 28.00 Marcain 85.00 Marcain 42.00 Marcain Isobaric 29.35 Marcain Heavy 24.50

BUPIVACAINE HYDROCHLORIDE WITH FENTANYL Inj 0.125% with 2 µg fentanyl per ml, 15 ml prefilled syringe .......................... Biomed Inj 0.125% with 2 µg fentanyl per ml, 20 ml prefilled syringe .......................... Biomed Inf 0.125% with 2 µg fentanyl per ml, 100 ml bag .......................................... Bupafen Inf 0.125% with 2 µg fentanyl per ml, 200 ml bag .......................................... Bupafen BUSPIRONE HYDROCHLORIDE Tab 5 mg ................................................. Tab 10 mg ............................................... CAFFEINE CITRATE Inj 10 mg per ml, 2.5 ml ........................... Oral liq 10 mg per ml ................................ CALCIPOTRIOL Crm 50 µg per g ....................................... Oint 50 µg per g ....................................... Crm 50 µg per g ....................................... Oint 50 µg per g ....................................... Soln 50 µg per ml..................................... Soln 50 µg per ml..................................... CALCITONIN Inj 100 u per ml, 1 ml ...............................

61.50 78.00 200.00 200.00

10 10 10 10 100 100 5 25 ml 30 g 30 g 100 g 100 g 30 ml 60 ml 5

1% 1% 1% 1%

Jan-09 Jan-09 Jan-09 Jan-09

(B) (B) (B) (B)

Pacific Buspirone 28.00 Pacific Buspirone 17.00 Biomed Biomed Daivonex Daivonex Daivonex Daivonex Daivonex Daivonex Miacalcic 50.70 13.50 20.76 20.76 57.89 57.89 20.78 34.72 110.00

1% 1%

Nov-06 Nov-06

(B) (B)

Dec-08

(B)

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 13.45 24.95 39.40 6.54 100 100 10 ml 30

DV Limit

DV Limit applies from Feb-07 Feb-07

DV Pharmaceuticals

CALCITRIOL Cap 0.25 µg ............................................ Cap 0.5 µg ............................................... Oral liq 1 µg per ml ................................... CALCIUM Tab eff 1 g................................................ CALCIUM FOLINATE Inj 3 mg per ml, 1 ml ................................ Inj 50 mg.................................................. Inj 100 mg................................................ Inj 300 mg................................................ Inj 1 g....................................................... Tab 15 mg................................................ CALCIUM GLUCONATE Inj 10%, 10 ml .......................................... CALCIUM POLYSTYRENE SULPHONATE Powder .................................................... CANDESARTAN Tab 4 mg.................................................. Tab 8 mg.................................................. Tab 16 mg................................................ Tab 32 mg................................................ CAPECITABINE Tab 150 mg.............................................. Tab 500 mg.............................................. CAPSAICIN Crm 0.075% ............................................. CAPTOPRIL Tab 12.5 mg............................................. Tab 25 mg................................................ Tab 50 mg................................................

Calcitriol-AFT Calcitriol-AFT Rocaltrol Calsource

1% 1%

Rocaltrol Rocaltrol

Sept-08

Calci-Tab Effervescent

Mayne 17.10 Calcium Folinate 24.50 Ebewe Calcium Folinate 9.75 Ebewe Calcium Folinate 30.00 Ebewe Calcium Folinate100.00 Ebewe Mayne 63.89 Mayne Calcium Resonium Atacand Atacand Atacand Atacand Xeloda Xeloda Zostrix HP Apo-Captopril Apo-Captopril Apo-Captopril 21.40 169.85

5 5 1 1 1 10 10 300 g

1% 1% 1% 1%

Sept-08 Sept-08 Sept-08 Sept-08

Leucovorin Calcium Hospira (B) Leucovorin Calcium Hospira (B)

16.22 19.30 23.54 38.50 115.00 705.00 12.50 10.40 13.40 19.00

30 30 30 30 60 120 45 g 500 500 500 1% 1% 1% Dec-07 Dec-07 Dec-07 Capoten Captohexal Capoten Captohexal Capoten Captohexal

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST)

DV Limit

DV Limit applies from

DV Pharmaceuticals

CARBOPLATIN Inj 10 mg per ml, 5 ml .............................. Inj 10 mg per ml, 15 ml ............................ Inj 10 mg per ml, 45 ml ............................ Inj 10 mg per ml, 100 ml .......................... CARVEDILOL Tab 6.25 mg............................................. Tab 12.5 mg............................................. Tab 25 mg................................................ CEFACLOR MONOHYDRATE Cap 250 mg ............................................. Grans for oral liq 125 mg per 5 ml ............ CEFAZOLIN SODIUM Inj 500 mg................................................ Inj 1 g....................................................... CEFEPIME HYDROCHLORIDE Inj 1 g, 15 ml ............................................ Inj 2 g, 77 ml ............................................ CEFOTAXIME Inj 500 mg................................................ Inj 1 g....................................................... Inj 2 g....................................................... CEFOXITIN SODIUM Powder for inj 1 g ..................................... CEFTAZIDIME Inj 500 mg................................................ Inj 1 g....................................................... Inj 2 g.......................................................

Carboplatin Ebewe Carboplatin Ebewe Carboplatin Ebewe Carboplatin Ebewe Dilatrend Dilatrend Dilatrend

12.00 18.70 55.50 135.65

1 1 1 1

1% 1% 1%

Jan-07 Jan-07 Jan-07

(B) Mayne Mayne

21.00 27.00 33.75

30 30 30 100 1% 100 ml 1% Sept-07 Sept-07 Clorotir CEC Suspension Clorotir m-Cefazolin m-Cefazolin

Ranbaxy-Cefaclor28.90 Ranbaxy-Cefaclor 3.92

Hospira Hospira Maxipime Maxipime Cefotaxime Sandoz Cefotaxime Sandoz Cefotaxime Sandoz Mayne Fortum Fortum Fortum

5.00 8.00 23.00 46.00 1.69 1.90 2.60

5 5 1 1 1 1 1

1% 1%

Dec-08 Dec-08

1% 1% 1%

Oct-08 Oct-08 Oct-08

AFT AFT AFT

48.48 2.84 5.63 11.25

5 1 1 1 1% 1% 1% Sept-08 Sept-08 Sept-08 Novartis Novartis Hospira Novartis Ceftazidime 2GM Hospira

CEFTRIAXONE SODIUM Inj 500 mg................................................ Inj 1 g....................................................... Inf 2 g ...................................................... CEFUROXIME AXETIL Tab 250 mg..............................................

AFT AFT AFT Zinnat

3.99 5.40 10.50 29.40

1 1 1 50

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST)

DV Limit

DV Limit applies from

DV Pharmaceuticals

CEFUROXIME SODIUM Inj 750 mg................................................ Inj 1.5 g....................................................

Zinacef Zinacef

10.71 4.04

5 1

1% 1%

Aug-08 Aug-08

Axetine Pacific Zilisten Axetine Pacific Zilisten

CELIPROLOL Tab 200 mg.............................................. CETIRIZINE HYDROCHLORIDE Tab 10 mg................................................

Celol Zetop

19.00 2.21

180 100 1% Feb-09 Apo-Cetirizine Allerid-C Cetirizine Histaclear Razene Allerid-C Zyrtec (B) (B) PSM

Oral Liquid 1 mg per 1 ml ........................ CHLORAMPHENICOL Eye drops 0.5% ........................................ Eye oint 1% .............................................. CHLORHEXIDINE Crm 1% obstetric ...................................... CHLOROTHIAZIDE Oral liq 50 mg per ml ................................ CHLORTHALIDONE Tab 25 mg................................................ CHOLECALCIFEROL Tab 50,000 iu ........................................... CILAZAPRIL Tab 0.5 mg............................................... Tab 2.5 mg...............................................

Cetirizine-AFT

3.50

200 ml 1%

Feb-09

Chlorsig Chlorsig Orion Biomed Hygroton Cal-d-Forte

1.40 2.48 1.70 22.60 8.00 10.35

10 ml 4g 50 g 25 ml 50 12

1% 1% 1%

Dec-06 Dec-06 Sept-06

Nov-06

(B)

Inhibace 2.20 30 Inhibace 4.10 28 Inhibace 4.39 30 Tab 5 mg.................................................. Inhibace 6.01 28 Inhibace 6.44 30 Note – the 30 tab pack of Inhibace brand of cilazapril tabs 2.5 mg and 5 mg will be delisted from 1 April 2009 CILAZAPRIL WITH HYDROCHLOROTHIAZIDE Tab 5 mg with 12.5 mg ............................ Inhibace Plus 6.30 28

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST)

DV Limit

DV Limit applies from

DV Pharmaceuticals

CIPROFLOXACIN Tab 250 mg.............................................. Tab 500 mg.............................................. Tab 750 mg.............................................. Inj 2 mg per ml, 100 ml ............................

Rex Medical Rex Medical Rex Medical Aspen Ciprofloxacin

3.35 4.90 7.54 75.00

30 30 30 10

1% 1% 1% 1%

Jan-09 Jan-09 Jan-09 Sept-07

Cifran Cipflox Cifran Cipflox Cifran Cipflox Ciproxin Ciprofloxacin (AFT) m-Ciprofloxacin Topistin Ufexil

CISPLATIN Inj 1 mg per ml, 50 ml .............................. Inj 1 mg per ml, 100 ml ............................ CITALOPRAM HYDROBROMIDE Tab 20 mg................................................

Cisplatin Ebewe Mayne Cisplatin Ebewe Mayne

19.00 19.00 38.00 38.00

1 1 1 1 84 1% Jan-09 Apo-Citalopram Celapram Cipramil Citalopram-Rex

Arrow-Citalopram 3.78

CLADRIBINE Inj 1 mg per ml, 10 ml .............................. CLARITHROMYCIN Grans for oral liq 125 mg per 5 ml ............ Tab 250 mg.............................................. CLINDAMYCIN Cap 150 mg ............................................. Inj phosphate 150 mg per ml, 4 ml .............................. CLOBETASOL PROPIONATE Crm 0.05% ............................................... CLOMIPHENE CITRATE Tab 50 mg................................................ CLOMIPRAMINE HYDROCHLORIDE Tab 25 mg................................................ CLONAZEPAM Inj 1 mg per ml, 1 ml ................................ Tab 500 mcg ............................................ Tab 2 mg..................................................

Leustatin Klacid Klamycin

5,249.72 23.12 7.75

7 70 ml 14 1% 1% Sept-07 Mar-08 (B) Clarac Klacid

Dalacin C Dalacin C Dermol Phenate Clopress Rivotril Paxam Paxam

11.39 19.45 2.35 2.50 26.00 9.36 6.26 11.15

16 1 30 g 5 500 5 100 100 1% Dec-06 Dermovate

1% 1%

Dec-08 Dec-08

(B) (B)

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST)

DV Limit

DV Limit applies from

DV Pharmaceuticals

CLONIDINE Inj 150 µg per ml, 1 ml ............................. Tab 150 µg .............................................. TDDS 2.5 mg, 100 µg per day .................. TDDS 5 mg, 200 µg per day ..................... TDDS 7.5 mg, 300 µg per day .................. CLOPIDOGREL Tab 75 mg................................................ CLOSTRIDUM BOTULINUM Inj 100 u................................................... Inj 500 u................................................... CLOTRIMAZOLE Crm 1% ....................................................

Catapres Catapres Catapres-TTS-1 Catapres-TTS-2 Catapres-TTS-3

14.00 30.33 21.29 30.79 39.10

5 100 4 4 4 28 28 1 2 20 g

Apo-Clopidogrel 35.00 Plavix 73.38 Botox Dysport Clomazol 467.50 1,295.00 0.50

1% 1%

Sept-06 Sept-08

(B) Canesten Clocreme Clotrimaderm 1% Fungizid Canesten Clocreme Clotrimaderm 1% Fungizid Canesten Clotrimaderm 2%

Vaginal crm 1% with applicator(s) .............

Clomazol

1.45

35 g

Sept-07

Vaginal crm 2% with applicator(s) ............. CLOZAPINE Oral liq 50 mg per ml ................................ Tab 25 mg ............................................... Tab 50 mg ............................................... Tab 100 mg ............................................. Tab 200 mg ............................................. COCAINE Soln 4%, 2 ml ........................................... CODEINE PHOSPHATE Tab 15 mg................................................ Tab 30 mg................................................ Tab 60 mg................................................ COLASPASE (L-ASPARAGINASE) Inj 10,000 iu ............................................. COLCHICINE Tab 500 µg ..............................................

Clomazol

2.75

20 g

Jan-09

Clopine Clozaril Clopine Clopine Clopine Clopine Clozaril Clopine Clopine Clopine Clopine Biomed PSM PSM PSM Leunase Colgout

45.60 13.37 26.74 17.33 34.65 34.65 69.30 55.45 110.90 25.46 5.50 8.50 18.50 102.32 9.60

100 ml 50 100 50 100 50 100 50 100 1 100 100 100 1 100 1% Sept-07 Colchicine Abbott 1% 1% 1% 1% Nov-06 Mar-08 Mar-08 Mar-08 (B) (B) (B) (B)

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 65.00 1.99 14.95 25.71 21.51 43.00 85.00 169.34 338.69 377.38 276.30 23.50 1 10 5 50 1 1 50 50 50 50 ml 10 50

DV Limit

DV Limit applies from Dec-07 Feb-07

DV Pharmaceuticals

COLISTIN SULPHOMETHATE Inj 150 mg................................................ CYCLIZINE HYDROCHLORIDE Tab 50 mg................................................ CYCLIZINE LACTATE Inj 50 mg per ml, 1 ml .............................. CYCLOPHOSPHAMIDE Tab 50 mg................................................ Inj 1 g....................................................... Inj 2 g....................................................... CYCLOSPORIN Cap 25 mg .............................................. Cap 50 mg .............................................. Cap 100 mg ............................................. Oral liq 100 mg per ml ............................. Inf 50 mg per ml, 5 ml .............................. CYPROTERONE ACETATE Tab 50 mg................................................

Colistin-Link Nausicalm Valoid (AFT) Cycloblastin Endoxan Endoxan Neoral Neoral Neoral Neoral Sandimmun Siterone

1% 1%

(B) Marzine

Aug-07

Endoxan

Oct-06

Androcur Pacific Cyproterone Procur

CYTARABINE Inj 100 mg per ml, 5 ml ............................ Inj 100 mg per ml, 10 ml .......................... Inj 100 mg per ml, 20 ml .......................... DACARBAZINE Inj 200 mg................................................ DACLIZUMAB Inj 25 mg per 5 ml vial .............................. DALTEPARIN SODIUM Inj 2,500 iu per 0.2 ml prefilled syringe.................................... Inj 5,000 iu per 0.2 ml prefilled syringe.................................... Inj 7,500 iu per 0.75 ml graduated syringe ................................ Inj 10,000 iu per 1 ml graduated syringe ................................ Inj 12,500 iu per 0.5 ml prefilled syringe.................................... Inj 15,000 iu per 0.6 ml prefilled syringe.................................... Inj 18,000 iu per 0.72 ml prefilled syringe....................................

Mayne Mayne Mayne Mayne Zenapax

95.36 42.65 34.47 43.86 635.00

5 1 1 1 1 1% 5% Aug-06 Apr-06 (B) (B)

Fragmin Fragmin Fragmin Fragmin Fragmin Fragmin Fragmin

49.00 52.30 78.85 105.12 84.50 105.00 125.00

10 10 10 10 5 5 5

1% 1% 1% 1% 1% 1% 1%

Nov-06 Nov-06 Nov-06 Nov-06 Nov-06 Nov-06 Nov-06

(B) (B) (B) (B) (B) (B) (B)

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 17.00 25.00 32.96 51.70 800.00 99.00 99.00 29.94 36.40 39.90 21.50 31.00 17.00 30 30 100 100 6 1 10 6 ml 30 25 ml 5 5 100

DV Limit

DV Limit applies from

DV Pharmaceuticals

DANAZOL Cap 100 mg ............................................. Cap 200 mg ............................................. DANTROLENE SODIUM Cap 25 mg ............................................... Cap 50 mg ............................................... Inj 1 mg per ml, 20 ml .............................. DAUNORUBICIN Inj 5 mg per ml, 4 ml ................................ DESFERRIOXAMINE MESYLATE Inj 500 mg ............................................... DESMOPRESSIN Nasal spray 10 µg per dose ...................... Tab 100 µg .............................................. DEXAMETHASONE Oral liq 1 mg per ml .................................. DEXAMETHASONE SODIUM PHOSPHATE Inj 4 mg per ml, 1 ml ................................ Inj 4 mg per ml, 2 ml ................................ DEXAMPHETAMINE SULPHATE Tab 5 mg.................................................. DEXTRAN 70 WITH SODIUM CHLORIDE Inf 6% with 0.9% sodium chloride, 500 ml ................................................. DEXTROSE Inj 50%, 10 ml .......................................... Inj 50%, 90 ml .......................................... DIAZEPAM Inj 5 mg per ml, 2 ml ................................ Rectal tubes 5 mg .................................... Rectal tubes 10 mg .................................. Tab 2 mg.................................................. Tab 5 mg.................................................. Tab 10 mg................................................ DICLOFENAC SODIUM Eye drops 1 mg per ml ............................. Inj 25 mg per ml, 3 ml .............................. Suppos 12.5 mg....................................... Suppos 25 mg.......................................... Suppos 50 mg.......................................... Suppos 100 mg........................................ Tab long-acting 75 mg..............................

D-Zol D-Zol Dantrium Dantrium Dantrium IV Mayne Mayne Desmopressin PH&T Minirin Biomed Mayne Mayne PSM

1% 1% 1%

Sept-06 Sept-06 Nov-06

(B) (B) (B)

1% 1%

Sept-07 Sept-08

(B) Minirin

1% 1% 1%

Aug-06 Aug-06 Apr-08

(B) (B) (B)

Baxter Biomed Biomed Mayne Stesolid Stesolid Pro-Pam Pro-Pam Pro-Pam Voltaren Ophtha Voltaren Voltaren Voltaren Voltaren Voltaren Diclax

16.59 22.75 11.25 9.24 27.83 33.89 8.40 5.00 3.45 13.80 12.00 1.85 2.22 3.84 6.36 3.10

1 5 1 5 5 5 500 250 100 5 ml 5 10 10 10 10 30 1% 1% 1% 1% 1% 1% Sept-08 Sept-08 Sept-08 Sept-08 Sept-08 Sept-08 (B) (B) (B) (B) (B) (B) 1% 1% Jul-08 Dec-06 Mayne (B)

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 4.50 8.50 4.72 7.08 9.44 52.65 64.60 11.52 24.30 460.00 1,650.00 100 100 30 30 30

DV Limit

DV Limit applies from Jun-09 Jun-09 Jun-09 Jun-09 Jun-09 Sept-06 Sept-06 Oct-08

DV Pharmaceuticals

DILTIAZEM HYDROCHLORIDE Tab 30 mg................................................ Tab 60 mg................................................ Cap long-acting 120 mg ........................... Cap long-acting 180 mg ........................... Cap long-acting 240 mg ........................... DINOPROSTONE Gel 1 mg .................................................. Gel 2 mg .................................................. DIPYRIDAMOLE Tab long-acting 150 mg............................ DISULFIRAM Tab 200 mg.............................................. DOCETAXEL Inj 20 mg.................................................. Inj 80 mg.................................................. DOCUSATE SODIUM WITH SENNOSIDES Tab 50 mg with total sennosides 8 mg ................... DOPAMINE HYDROCHLORIDE Inj 40 mg per ml, 5 ml .............................. DOTHIEPIN HYDROCHLORIDE Cap 25 mg ............................................... Tab 75 mg................................................ DOXAZOSIN MESYLATE Tab 2 mg ................................................. Tab 4 mg.................................................. DOXORUBICIN Inj 10 mg.................................................. Inj 50 mg.................................................. Inj 100 mg................................................ Inj 200 mg................................................ DOXYCYCLINE HYDROCHLORIDE Tab 100 mg.............................................. EMTRICITABINE Cap 200 mg .............................................

Dilzem Dilzem Cardizem CD Cardizem CD Cardizem CD Prostin E2 Prostin E2 Pytazen SR Antabuse Taxotere Taxotere

5% 5% 5% 5% 5%

(B) (B) (B) Dilzem LA Dilzem LA (B) (B) Persantin

2.5 ml 1% 2.5 ml 1% 60 100 1 1 1%

Laxsol Mayne Dopress Dopress

7.98 54.00 4.75 8.75

200 5 100 100 500 100 500 1 1 1 1

1% 1%

Sept-06 Oct-06

(B) (B)

Apo-Doxazosin 22.85 Apo-Doxazosin 6.37 Apo-Doxazosin 30.26 Doxorubicin Ebewe Doxorubicin Ebewe Doxorubicin Ebewe Doxorubicin Ebewe Doxine Emtriva 8.80 39.40 81.00 162.00

1% 1% 1% 1% 1% 1% 1%

Jan-09 Jan-08 Jan-09 Sept-06 Sept-06 Sept-06 Sept-06

Dosan Dosan Dosan Adriamycin Asta Medica Mayne Adriamycin Asta Medica Mayne Mayne Adriamycin Mayne

8.10 307.20

250 30

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 2.50 3.69 100 g 500 g

DV Limit

DV Limit applies from Nov-08 Sept-08

DV Pharmaceuticals

EMULSIFYING OINTMENT Ointment BP ............................................. Ointment BP ............................................. ENFUVIRTIDE Powder for inj 90 mg per ml x 60 .............. ENTACAPONE Tab 200 mg.............................................. EPHEDRINE SULPHATE Inj 30 mg per ml, 1 ml .............................. EPIRUBICIN Inj 2 mg per ml, 5 ml ................................ Inj 2 mg per ml, 25 ml .............................. Inj 2 mg per ml, 50 ml .............................. Inj 2 mg per ml, 100 ml ............................ EPTIFIBATIDE Inj 2 mg per ml, 10 ml .............................. Inj 0.75 mg per ml, 100 ml ....................... ERGOMETRINE MALEATE Inj 500 µg per ml, 1 ml ............................. ERTAPENEM SODIUM Inj 1 g....................................................... ERYTHROMYCIN ETHYL SUCCINATE Tab 400 mg.............................................. Grans for oral liq 200 mg per 5 ml ............ Grans for oral liq 400 mg per 5 ml ............ ERYTHROMYCIN LACTOBIONATE Inj 300 mg................................................ Inj 1 g.......................................................

AFT AFT

1% 1%

(B) IPW Sigma

Fuzeon Comtan Mayne Epirubicin Ebewe Epirubicin Ebewe Epirubicin Ebewe Epirubicin Ebewe Integrilin Integrilin Mayne Invanz E-Mycin E-Mycin E-Mycin Mayne Erythrocin IV

2,380.00 129.00 44.00 24.70 123.50 247.00 494.00

1 100 5 1 1 1 1 1% 1% 1% 1% 1% Oct-06 Sept-06 Sept-06 Sept-06 Sept-06 (B) Mayne Pharmorubicin Mayne Pharmorubicin (B) Pharmorubicin

111.00 324.00 11.60 70.00 18.95 4.35 5.85 70.97 6.50

1 1 5 1 100 100 ml 1% 100 ml 1% 5 1 1% Sept-06 (B)

Dec-08 Dec-08

(B) (B)

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST)

DV Limit

DV Limit applies from

DV Pharmaceuticals

ERYTHROPOIETIN ALPHA Inj human recombinant 1,000 iu, pre-filled syringe .................................. Inj human recombinant 2,000 iu, pre-filled syringe .................................. Inj human recombinant 3,000 iu, pre-filled syringe .................................. Inj human recombinant 4,000 iu, pre-filled syringe .................................. Inj human recombinant 5,000 iu, pre-filled syringe .................................. Inj human recombinant 6,000 iu, pre-filled syringe .................................. Inj human recombinant 10,000 iu, pre-filled syringe .................................. ERYTHROPOIETIN BETA Inj 1,000 iu prefilled syringe ...................... Inj 2,000 iu prefilled syringe ...................... Inj 3,000 iu prefilled syringe ...................... Inj 4,000 iu prefilled syringe ...................... Inj 5,000 iu prefilled syringe ...................... Inj 6,000 iu prefilled syringe ...................... Inj 10,000 iu prefilled syringe .................... ETANERCEPT Inj 25 mg.................................................. ETIDRONATE DISODIUM Tab 200 mg.............................................. ETOPOSIDE Cap 50 mg ............................................... Cap 100 mg ............................................. Inj 20 mg per ml, 5 ml .............................. EXEMESTANE Tab 25 mg................................................ FELODIPINE Tab long-acting 5 mg................................ Tab long-acting 10 mg.............................. FENTANYL Inj 50 µg per ml, 2 ml ............................... Inj 50 µg per ml, 10 ml .............................

Eprex Eprex Eprex Eprex Eprex Eprex Eprex Recormon Recormon NeoRecormon Recormon NeoRecormon Recormon NeoRecormon Recormon NeoRecormon Recormon NeoRecormon Recormon NeoRecormon Enbrel Didronel Etidrate Vepesid Vepesid Mayne Aromasin Felo 5 ER Felo 10 ER Hospira Hospira

48.68 120.18 166.87 193.13 243.26 291.92 395.18 48.68 120.18 152.04 166.87 228.06 193.13 304.08 243.26 380.10 291.92 456.12 395.18 760.20 949.96 22.80 38.00 340.73 340.73 25.00 175.00 16.50 24.00 6.10 15.65

6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 6 4 60 100 20 10 1 30 90 90 5 5 1% 1% Sept-06 Sept-06 (B) (B)

5% 5% 5% 5% 5% 5%

Apr-06 Apr-06 Apr-06 Apr-06 Apr-06 Apr-06

(B) (B) (B) (B) (B) (B)

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 3.75 3.95 10.30 100 60

DV Limit

DV Limit applies from

DV Pharmaceuticals

FERROUS FUMARATE Tab 200 mg.............................................. FERROUS FUMARATE WITH FOLIC ACID Tab 310 mg with folic acid 350 µg ........... FERROUS SULPHATE Oral liquid 150 mg per 5 ml ...................... FILGRASTIM Inj 300 µg per 0.5 ml prefilled syringe ................................................ Inj 300 µg per 1 ml vial............................. Inj 480 µg per 0.5 ml prefilled syringe ................................................ FINASTERIDE Tab 5 mg.................................................. FLUCLOXACILLIN Grans for oral liq 125 mg per 5 ml .................................. Grans for oral liq 250 mg per 5 ml ..................................

Ferro-tab Ferro-F-Tabs Ferodan

500 ml 1%

Jan-08

Ferro-liquid

Neupogen Neupogen Neupogen Fintral

135.00 650.00 216.00 19.20

1 5 1 30

1% 1% 1% 1%

Jun-09 Jun-09 Jun-09 Dec-08

(B) (B) (B) Proscar

AFT

2.05

100 ml 1%

Sept-06

Floxapen Flucloxin Staphlex Floxapen Flucloxin Staphlex AFT Flucloxin AFT Flucloxin Floxapen Floxapen Floxapen Diflucan IV (B) Flucoran m-Fluconazole Diflucan Rex Canesten Fluconazole Flucoran Diflucan One m-Fluconazole Diflucan Rex Flucoran m-Fluconazole Diflucan Rex

AFT

2.72

100 ml 1%

Sept-06

FLUCLOXACILLIN SODIUM Cap 250 mg ............................................. Cap 500 mg ............................................. Inj 250 mg................................................ Inj 500 mg................................................ Inj 1 g....................................................... FLUCONAZOLE Inj 2 mg per ml, 50 ml .............................. Oral liq 10 mg per ml ................................ Cap 50 mg ...............................................

Staphlex Staphlex Flucloxin Flucloxin Flucloxin m-Fluconazole Diflucan POS Pacific

18.50 57.90 9.00 10.40 14.00 7.10 34.56 6.82

250 500 10 10 10 1 35 ml 28

1% 1% 1% 1% 1% 1% 1% 1%

Sept-06 Sept-06 Feb-09 Feb-09 Feb-09 Feb-07 Nov-06 Sept-08

Cap 150 mg ............................................

Pacific

1.30

Sept-08

Cap 200 mg .............................................

Pacific

19.05

Sept-08

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 650.25 1,430.00 7.62 170.10 15 5 100 5

DV Limit

DV Limit applies from Nov-08 Nov-08

DV Pharmaceuticals

FLUDARABINE Tab 10 mg................................................ FLUDARABINE PHOSPHATE Inj 50 mg ................................................. FLUDROCORTISONE ACETATE Tab 100 µg .............................................. FLUMAZENIL Inj 0.5 mg per 5 ml amp ...........................

Fludara Fludara Florinef Anexate

1% 1%

(B) (B)

FLUOCORTOLONE CAPROATE WITH FLUOCORTOLONE PIVALATE AND CINCHOCAINE Oint 950 µg, wtih fluocortolone pivalate 920 µg, and cinchocaine hydrochloride 5 mg per g ........................................... Ultraproct 6.35 30 g 1% Suppos 630 µg, with fluocortolone pivalate 610 µg, and cinchocaine hydrochloride 1 mg.................................................... FLUOROMETHOLONE Eye drops 0.1% ........................................ FLUOROURACIL SODIUM Crm 5% .................................................... Inj 25 mg per ml, 20 ml ............................ Inj 25 mg per ml, 100 ml .......................... Inj 50 mg per ml, 10 ml ............................ Inj 50 mg per ml, 20 ml ............................ Inj 50 mg per ml, 50 ml ............................ Inj 50 mg per ml, 100 ml .......................... FLUOXETINE HYDROCHLORIDE Cap 20 mg ............................................... Tab disp 20 mg, scored ............................ FLUPENTHIXOL DECANOATE Inj 20 mg per ml, 1 ml .............................. Inj 20 mg per ml, 2 ml .............................. Inj 100 mg per ml, 1 ml ............................ FLUPHENAZINE DECANOATE Inj 12.5 mg per 0.5 ml, 0.5 ml .................. Inj 25 mg per ml, 1 ml .............................. Inj 100 mg per ml, 1 ml ............................

Sept-07

Proctosedyl Xyloproct Proctosedyl Xyloproct FML

Ultraproct

2.66

Sept-07

Flucon Efudix Mayne Mayne Fluorouracil Ebewe Fluorouracil Ebewe Fluorouracil Ebewe Fluorouracil Ebewe Fluox Fluox

4.30 26.49 55.60 13.55 4.95 8.60 21.50 43.00

5 ml 20 g 10 1 1 1 1 1

Sept-06

1% 1% 1% 1% 1%

Oct-07 Oct-07 Oct-07 Oct-07 Oct-07

(B) Mayne Mayne Mayne (B)

4.39 5.50

90 30

1% 1%

Mar-08 Mar-08

Apo-Fluoxetine Flexetor Prozac Lovan Prozac

Fluanxol Fluanxol Fluanxol Modecate Modecate Modecate

13.14 20.90 40.87 17.60 27.90 154.50

5 5 5 5 5 5

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 39.50 100

DV Limit

DV Limit applies from

DV Pharmaceuticals

FLUTAMIDE Tab 250 mg ............................................. FLUTICASONE WITH SALMETEROL Aerosol inhaler 50 µg with salmeterol 25 µg.................................. Aerosol inhaler 125 µg with salmeterol 25 µg.................................. Powder for inhalation 100 µg with salmeterol 50 µg .......................... Powder for inhalation 250 µg with salmeterol 50 µg .......................... FOLIC ACID Oral liq 50 µg per ml ................................. FRUSEMIDE Inj 10 mg per ml, 2 ml .............................. Tab 40 mg................................................ Tab 500 mg.............................................. FUSIDIC ACID Crm 2% .................................................... Oint 2% .................................................... Tab 250 mg.............................................. Eye drops 1% ........................................... GABAPENTIN Cap 100 mg ............................................. Cap 300 mg ............................................. Cap 400 mg ............................................. Tab 600 mg.............................................. GADOBENDATE DIMEGLUMINE Inj 0.5 g per litre, 10 ml ............................ Inj 0.5 g per litre, 20 ml ............................ GANCICLOVIR Inj 500 mg vial.......................................... GELATIN PLASMA REPLACER Inf 3.5%, 500 ml bag ................................ Inf 4% per 500 ml bag .............................. GEMCITABINE HYDROCHLORIDE Inj 200 mg................................................ Inj 1 g.......................................................

Flutamin

Seretide Seretide Seretide Accuhaler Seretide Accuhaler Biomed Mayne Diurin 40 Diurin 500 Foban Foban Fucidin Fucithalmic Nupentin Neurontin Nupentin Neurontin Nupentin Neurontin Neurontin Multihance Multihance Cymevene Haemaccel Gelofusine Gemzar Gemzar

37.48 49.69 37.48 49.69

120 dose 120 dose 60 dose 60 dose

21.05 29.50 11.50 12.00 3.95 3.95 34.50 9.83 13.26 15.67 39.76 47.00 53.01 62.66 79.79 324.74 636.28 380.00 9.75 108.00 78.00 349.20

25 ml 50 1,000 100 15 g 15 g 12 5g 100 100 100 100 100 100 100 10 10 5 1 10 1 1 1% 1% Sept-07 Sept-07 Fucidin Fucidin

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 8.56 4.56 11.40 22.24 3.50 2.87 2.64 3.35 1.75 1.78 2.47 4.77 6.09 5 10 5 ml 500 100 1 1 1 1 1 1 1 1

DV Limit

DV Limit applies from

DV Pharmaceuticals

GENTAMICIN SULPHATE Inj 10 mg per ml, 1 ml .............................. Inj 40 mg per ml, 2 ml ............................. Eye drops 0.3% ....................................... GLICLAZIDE Tab 80 mg................................................ GLIPIZIDE Tab 5 mg.................................................. GLUCOSE Inf 5%, 50 ml ............................................ Inf 5%, 100 ml .......................................... Inf 5%, 250 ml .......................................... Inf 5%, 500 ml .......................................... Inf 5%, 1,000 ml ....................................... Inf 10%, 500 ml ........................................ Inf 10%, 1,000 ml ..................................... Inf 50%, 500 ml ........................................

Mayne Pfizer Genoptic Apo-Gliclazide Minidiab Baxter Baxter Baxter Baxter Baxter Baxter Baxter Baxter

Aug-06

Mayne

1% 1%

Sept-08 Sept-08

Glizon (B)

GLUCOSE WITH SODIUM, POTASSIUM, MAGNESIUM, CHLORIDE, ACETATE AND GLUCONATE Inf 50 g with 140 mmol.L-1 sodium, 5 mmol.L-1 potassium, 1.5 mmol.L-1 magnesium, 98 mmol.L-1 chloride, 27 mmol.L-1 acetate and 23 mmol.L-1 gluconate, 1,000 ml ............................. Baxter 4.50 1 GLUCOSE WITH SODIUM, POTASSIUM, MAGNESIUM, CHLORIDE AND ACETATE Inf 50 g with 40 mmol.L-1 sodium, 13 mmol.L-1 potassium, 1.5 mmol.L-1 magnesium, 40 mmol.L-1 chloride and 16 mmol.L-1 acetate, 500 ml ................................................. Baxter 4.50 1 GLYCEROL Liquid ....................................................... Suppos 3.6 g............................................ GLYCERYL TRINITRATE Aerosol spray 400 µg per dose ................. Inj 1 mg per ml, 5 ml ................................ Inj 1 mg per ml, 50 ml .............................. Inj 5 mg per ml, 10 ml .............................. Tab 600 µg .............................................. TDDS 5 mg ............................................. TDDS 10 mg ........................................... ABM PSM Nitrolingual Pumpspray Nitronal Nitronal Mayne Lycinate Nitroderm TTS 5 Nitroderm TTS 10 19.80 5.00 5.16 21.00 80.01 40.00 8.00 16.56 19.60 2000 ml 20 250 doses 10 10 5 100 30 30 1% 1% 1% 1% 1% 1% 1% Sept-08 Nov-06 Nov-06 Sept-06 Mar-09 Jul-08 Jul-08 (B) (B) (B) (B) (B) Minitran Nitrocor Nitro-Dur Minitran Nitrocor Nitro-Dur

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 221.60 554.70 4.93 7.45 23.49 18.06 17.04 28.39 55.90 1 1 100 100 100 100 ml 10 5 5

DV Limit

DV Limit applies from

DV Pharmaceuticals

GOSERELIN ACETATE Inj 3.6 mg................................................. Inj 10.8 mg............................................... HALOPERIDOL Tab 500 µg .............................................. Tab 1.5 mg............................................... Tab 5 mg.................................................. Oral liq 2 mg per ml .................................. Inj 5 mg per ml, 1 ml ................................ HALOPERIDOL DECANOATE Inj 50 mg per ml, 1 ml .............................. Inj 100 mg per ml, 1 ml ............................ HEPARINISED SALINE Inj 10 iu per ml, 5 ml ................................ Inj 100 iu per ml, 5 ml .............................. HEPARIN SODIUM Inj 1,000 iu per ml, 1 ml ........................... Inj 5,000 iu per ml, 1 ml ........................... HEPARIN WITH SODIUM CHLORIDE Inf 25,000 iu with 0.9% sodium chloride, 250 ml ................................... Inf 25,000 iu with 0.9% sodium chloride, 500 ml ................................... HYDRALAZINE Inj 20 mg per ml, 1 ml .............................. HYDROCORTISONE Tab 5 mg.................................................. Tab 20 mg................................................ Crm 1% .................................................... Crm 1% .................................................... HYDROCORTISONE ACETATE Rectal foam 10%, CFC-Free (14 applications) .................................. HYDROCORTISONE BUTYRATE Lipocream 0.1% ....................................... Lipocream 0.1% ....................................... Milky emulsion 0.1% ................................ Oint 0.1% ................................................. HYDROCORTISONE WITH MICONAZOLE Crm 1% with miconazole nitrate 2% .......... HYDROGEN PEROXIDE Crm 1% ....................................................

Zoladex Zoladex Serenace Serenace Serenace Serenace Serenace Haldol Haldol Concentrate AstraZeneca Mayne Mayne Mayne

18.00 103.76 66.80 10.32

50 50 50 5

Sept-06

Baxter Pfizer

Oct-06

(B)

Baxter Baxter Apresoline Douglas Douglas AFT PSM

7.25 7.67 25.90 7.95 19.95 2.48 12.20

1 1 5 1% Sept-06 Dec-06 Dec-06 Sept-08 (B) (B) (B) (B)

100 1% 100 1% 14.2 g 500 g 1%

Colifoam

21.10

21.1 g 1% 30 g 100 g 100 ml 100 g 15 g 10 g

Dec-06

(B)

Locoid Lipocream 5.00 Locoid Lipocream15.00 Locoid Crelo 15.00 Locoid Ointment 15.00 Micreme H Crystacide 2.20 8.56

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 9.21 10.84 31.09 31.76 3 3 100 100 2 5 5 20 15 ml

DV Limit

DV Limit applies from

DV Pharmaceuticals

HYDROXOCOBALAMIN Inj 1 mg per ml, 1 ml ................................ HYDROXYCHLOROQUINE SULPHATE Tab 200 mg.............................................. HYDROXYUREA Cap 500 mg ............................................. HYOSCINE (SCOPOLAMINE) Patches 1.5 mg ....................................... HYOSCINE HYDROBROMIDE Inj 400 µg per ml, 1 ml ............................. HYOSCINE N-BUTYLBROMIDE Inj 20 mg per ml, 1 ml .............................. Tab 10 mg................................................ HYPROMELLOSE Eye drops 0.5% ........................................ IBUPROFEN Oral liq 100 mg per 5 ml ........................... IDARUBICIN HYDROCHLORIDE Cap 5 mg ................................................. Cap 10 mg ............................................... Inj 5 mg.................................................... Inj 10 mg.................................................. IFOSFAMIDE Inj 1 g....................................................... Inj 2 g....................................................... IMATINIB MESYLATE Tab 100 mg.............................................. IMIPENEM WITH CILASTATIN Inj 500 mg with cilastatin 500 mg ............. IMIPRAMINE HYDROCHLORIDE Tab 10 mg................................................ Tab 25 mg................................................ IMIQUIMOD Cream 5 %, sachet ................................... INDAPAMIDE Tab 2.5 mg............................................... INFLIXIMAB Powder for inj 100 mg ..............................

ABM Neo-B12 Plaquenil Hydrea

Scopoderm TTS 11.95 Mayne Buscopan Gastrosoothe Methopt Fenpaed Zavedos Zavedos Zavedos Zavedos Holoxan Holoxan Glivec Primaxin Tofranil Tofranil Aldara Napamide Remicade 6.66 8.04 1.62 2.00 3.49 80.75 144.50 170.00 340.00 87.26 162.80 2,400.00 21.61 5.48 8.80 110.40 4.00 1,227.00

1% 1% 1%

Dec-08 Dec-08 Mar-09 Oct-07 Aug-06 Aug-06 Aug-06 Aug-06

(B) Buscopan (B) Nurofen (B) (B) (B) (B)

200 ml 1% 1 1 1 1 1 1 60 1 50 50 12 100 1 1% 1% 1% 1% 1% 1% 1%

Dec-06 Dec-06

(B) (B)

Dec-06

Naplin

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 5 5 1

DV Limit

DV Limit applies from

DV Pharmaceuticals

INSULIN GLARGINE Inj 100 u per ml, 3 ml ............................... Inj 100 u per ml, 10 ml .............................

Lantus 94.50 Lantus SoloStar 94.50 Lantus 63.00

INSULIN LISPRO WITH INSULIN LISPRO PROTAMINE Inj lispro 25% with insulin lispro protamine 75%, 100 u per ml, 3 ml ...... Humalog Mix 25 52.15 Inj lispro 50% with insulin lispro protamine 50%, 100 u per ml, 3 ml ...... Humalog Mix 50 52.15 INSULIN PEN NEEDLES 29 g x 12.7 mm........................................ 31 g x 6 mm............................................. 31 g x 8 mm............................................. ABM ABM ABM 11.75 11.75 11.75

5 5 100 100 100

INSULIN SYRINGES, DISPOSABLE WITH ATTACHED NEEDLE Syringe 0.3 ml with 29 g x 12.7 mm needle ........................ ABM Syringe 0.3 ml with 31 g x 8 mm needle ............................. ABM Syringe 0.5 ml with 29 g x 12.7 mm needle ........................ ABM Syringe 0.5 ml with 31 g x 8 mm needle ............................. ABM Syringe 1 ml with 29 g x 12.7 mm needle ........................ ABM Syringe 1 ml with 31 g x 8 mm needle ............................. ABM IODIXANOL Inj 270 mg per ml (iodine equivalent), 50 ml ................................................... Inj 270 mg per ml (iodine equivalent), 100 ml ................................................. Inj 320 mg per ml (iodine equivalent), 50 ml ................................................... Inj 320 mg per ml (iodine equivalent), 100 ml ................................................. Inj 320 mg per ml (iodine equivalent), 200 ml ................................................. IOHEXOL Inj 240 mg per ml (iodine equivalent), 50 ml ................................

14.45 14.45 14.45 14.45 14.45 14.45

100 100 100 100 100 100

Visipaque Visipaque Visipaque Visipaque Visipaque

235.60 471.30 235.60 471.30 565.56

10 10 10 10 6

5% 5% 5% 5% 5%

Mar-07 Mar-07 Mar-07 Mar-07 Mar-07

(B) (B) (B) (B) (B)

Omnipaque

88.00

Mar-07

Iomeron Isovue 50 ml & 100 ml Optiray Ultravist Iomeron Isovue Optiray 20 ml & 30 ml Ultravist

Inj 300 mg per ml (iodine equivalent), 20 ml ................................

Omnipaque

35.40

Mar-07

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST)

DV Limit

DV Limit applies from

DV Pharmaceuticals

Inj 300 mg per ml (iodine equivalent), 50 ml ................................

Omnipaque

88.00

Mar-07

Iomeron Isovue Optiray Ultraject 50 ml & 75 ml Ultravist Iomeron Isovue Optiray 100 ml, 150 ml & 200 ml Ultraject 125 ml Ultravist (B) Iomeron Isovue Optiray 20 ml & 30 ml Ultraject 30 ml Ultravist 30 ml Iomeron Isovue Optiray Ultraject Ultravist Iomeron Optiray Ultraject Iomeron Isovue Optiray Ultraject 100 ml & 125 ml Ultravist Iomeron Isovue Optiray Ultravist (B)

Inj 300 mg per ml (iodine equivalent), 100 ml ..............................

Omnipaque

176.00

Mar-07

Inj 300 mg per ml (iodine equivalent), 500 ml .............................. Inj 350 mg per ml (iodine equivalent), 20 ml ................................

Omnipaque Omnipaque

527.88 35.40

6 6

5% 5%

Mar-07 Mar-07

Inj 350 mg per ml (iodine equivalent), 50 ml ................................

Omnipaque

88.00

Mar-07

Inj 350 mg per ml (iodine equivalent), 75 ml ................................ Inj 350 mg per ml (iodine equivalent), 100 ml ..............................

Omnipaque

132.00

Mar-07

Omnipaque

176.00

Mar-07

Inj 350 mg per ml (iodine equivalent), 200 ml ..............................

Omnipaque

211.20

Mar-07

Inj 350 mg per ml (iodine equivalent), 500 ml .............................. IPRATROPIUM BROMIDE Nebuliser soln 250 µg per ml, 1 ml.............. Nebuliser soln 250 µg per ml, 2 ml..............

Omnipaque Ipratropium Steri-Neb Ipratropium Steri-Neb

879.80

Mar-07

4.30 5.25

20 20

1% 1%

Sept-07 Sept-07

IPRA 250 IPRA 500

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 124.00 310.00 20.95 99.00 1 1 5

DV Limit

DV Limit applies from Sept-06 Sept-06 Sept-08 Jan-07

DV Pharmaceuticals

IRINOTECAN Inj 20 mg per ml, 2 ml .............................. Inj 20 mg per ml, 5 ml .............................. IRON POLYMALTOSE Inj 50 mg per ml, 2 ml .............................. ISOFLURANE Liq 250 ml bottle ..................................... ISONIAZID Tab 100 mg.............................................. ISOSORBIDE MONONITRATE Tab 20 mg ............................................... Tab long-acting 60 mg.............................. ISOTRETINOIN Cap 10 mg ............................................... Cap 20 mg ............................................... ITRACONAZOLE Cap 100 mg ............................................. IVERMECTIN Tab 3 mg.................................................. KETOCONAZOLE Shampoo 2 % ........................................... LABETALOL Tab 50 mg................................................ Tab 100 mg.............................................. Tab 200 mg.............................................. Tab 400 mg.............................................. LACTULOSE Oral liq 10 g per 15 ml ..............................

Camptosar Camptosar Ferrum H Forthane

1% 1% 1%

(B) (B) Ferrosig Aerrane Rhodia

250 ml 1%

PSM Ismo-20 Duride

20.50 18.00 4.15

100 100 90

Sept-06

Imtrate

Isotane 10 Isotane 20 Sporanox Stromectol Sebizole

36.00 47.50 23.70 25.96 3.48

100 100 15 4

1% 1% 1% 1%

Sept-06 Sept-06 Aug-07 Oct-08 Oct-08

Oratane Roaccutane Oratane Roaccutane Itrazole (B) Ketopine Nizoral

100 ml 1%

Hybloc Hybloc Hybloc Hybloc Duphalac

8.66 10.59 18.47 34.44 6.65

100 100 100 100 1000 ml 1% Dec-07 Actilax Laevolac

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST)

DV Limit

DV Limit applies from

DV Pharmaceuticals

LAMOTRIGINE Tab dispersible 2 mg ................................ Tab dispersible 5 mg ................................ Tab dispersible 25 mg ..............................

Tab dispersible 50 mg ..............................

Tab dispersible 100 mg ...........................

Tab dispersible 200 mg ............................ LANSOPRAZOLE Cap 15 mg ............................................... Cap 30 mg ............................................... LEFLUNOMIDE Tab 10 mg................................................ Tab 20 mg................................................ Tab 100 mg.............................................. LETROZOLE Tab 2.5 mg............................................... LEUPRORELIN Inj 3.75 mg............................................... Inj 7.5 mg................................................. Inj 11.25 mg............................................. Inj 22.5 mg............................................... Inj 30 mg.................................................. Inj 45 mg.................................................. LEVOBUNOLOL Eye drops 0.25% ...................................... Eye drops 0.5% ........................................

Lamictal 6.74 Arrow-Lamotrigine 15.00 Lamictal 9.64 Arrow-Lamotrigine 20.40 Lamictal 29.09 Logem 19.38 Mogine 20.40 Arrow-Lamotrigine 34.70 Lamictal 47.89 Logem 32.97 Mogine 34.70 Arrow-Lamotrigine 59.90 Lamictal 79.16 Logem 56.91 Mogine 59.90 Arrow-Lamotrigine 101.80 Mogine 101.80 Solox Solox 4.30 8.59

30 56 30 56 56 56 56 56 56 56 56 56 56 56 56 56 56 28 28 30 30 30 30 3 30 1 1 1 1 1 1 5 ml 5 ml 1% 1% Aug-07 Aug-07 (B) AlconLevobunolol

AFT-Leflunomide 55.00 Arava 79.27 AFT-Leflunomide 76.00 Arava 108.60 Arava 54.44 Femara 200.00

Lucrin Depot 221.60 Eligard 184.90 Lucrin Depot 591.68 Eligard 554.70 Eligard 739.60 Eligard 1,109.40 Betagan Betagan 7.00 7.00

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST)

DV Limit

DV Limit applies from

DV Pharmaceuticals

LEVODOPA WITH BENSERAZIDE Cap 50 mg with benserazide 12.5 mg............................ Tab dispersible 50 mg with benserazide 12.5 mg............................ Cap 100 mg with benserazide 25 mg............................... Cap long-acting 100 mg with benserazide 25 mg............................... Cap 200 mg with benserazide 50 mg............................... LIGNOCAINE Gel 2% ..................................................... LIGNOCAINE HYDROCHLORIDE Inj 0.5%, 5 ml ........................................... Inj 1%, 2 ml .............................................. Inj 1%, 5 ml .............................................. Inj 1%, 20 ml ............................................ Inj 2%, 2 ml .............................................. Inj 2%, 5 ml .............................................. Inj 2%, 20 ml ............................................ Pump spray 10%, 50 ml CFC-free .............

Madopar 62.5 Madopar Dispersible Madopar 125 Madopar HBS Madopar 250 Orion Xylocaine Xylocaine Xylocaine Xylocaine Xylocaine Xylocaine Xylocaine Xylocaine

8.00 10.00 12.50 17.00 25.00 6.10 44.10 48.00 42.00 23.50 52.00 45.00 28.00 60.00

100 100 100 100 100 20 g 50 50 50 5 50 50 5 1

1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1%

Oct-06 Oct-06 Oct-06 Oct-06 Oct-06 Dec-06 Sept-07 Sept-06 Sept-06 Sept-06 Sept-06 Sept-06 Sept-06 Aug-07

(B) (B) (B) (B) (B) Xylocaine (B) (B) (B) (B) (B) CSL Pharmacia (B)

LIGNOCAINE HYDROCHLORIDE WITH ADRENALINE Inj 1% with 1:100,000 of adrenaline, 5 ml ................................... Xylocaine Inj 1% with 1:200,000 of adrenaline, 20 ml ................................. Xylocaine Inj 2% with 1:200,000 of adrenaline, 20 ml ................................. Xylocaine LIGNOCAINE WITH CHLORHEXIDINE Gel 2% with 0.05% chlorhexidine .............. LIGNOCAINE WITH PRILOCAINE Crm 2.5% with prilocaine 2.5%, 5 g .......... Crm 2.5% with prilocaine 2.5%, 30 g ....... Patch 2.5% with prilocaine 2.5% .............. Patch 2.5% with prilocaine 2.5% ............... LIPOSOMAL AMPHOTERICIN Inj 50 mg vial ........................................... LOPINAVIR WITH RITONAVIR Tab 200 mg with ritonavir 50 mg .............. Oral liq 80 mg with ritonavir 20 mg per ml .................................................. Pfizer EMLA EMLA EMLA EMLA AmBisome Kaletra Kaletra

18.00 44.00 49.50 43.26 41.00 41.00 10.40 104.00 3,450.00 735.00 735.00

10 5 5 10 5 1 2 20 10 120 300 ml

1% 1% 1% 1% 1% 1%

Aug-07 Aug-07 Aug-07 Nov-06 Sept-07 Sept-07

(B) (B) (B) (B) (B) (B)

Oct-06

(B)

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST)

DV Limit

DV Limit applies from

DV Pharmaceuticals

LORATADINE Oral liq 1 mg per ml .................................. Tab 10 mg................................................

Lorapaed

3.65

100 ml 1% 100 1%

Sept-07 Dec-07

Loraclear 3.58 Hayfever Relief

Claratyne Lorafast Apo-Loratadine Aridine Arrow-Loratadine Claratyne Lorastyne Lora-tabs Lorfast Tirlor Lorapam Lorzem Lorapam Lorzem

LORAZEPAM Tab 1 mg.................................................. Tab 2.5 mg............................................... MACROGOL 3350 Powder 13.125 g, sachets ........................ MAGNESIUM SULPHATE Inj 49.3%, 5 ml ......................................... MANNITOL Inf 10%, 1,000 ml ..................................... Inf 15%, 500 ml ........................................ Inf 20%, 500 ml ........................................ MEBENDAZOLE Tab 10 mg................................................ MEBEVERINE HYDROCHLORIDE Tab 135 mg.............................................. MEDROXYPROGESTERONE ACETATE Tab 2.5 mg............................................... Tab 5 mg.................................................. Tab 10 mg................................................ Tab 100 mg.............................................. Tab 200 mg.............................................. MEGESTROL ACETATE Tab 160 mg..............................................

Ativan Ativan

6.28 4.12

250 100

1% 1%

Dec-06 Dec-06

Movicol Mayne Baxter Baxter Baxter De-Worm Colofac Provera Provera Provera Provera Provera Megace

18.14 26.60 10.59 7.88 10.59 17.28 18.00 2.07 13.75 7.57 104.26 78.06 74.25

30 10 1 1 1 24 90 30 100 30 100 30 30 1% 1% 1% 1% 1% 1% 1% May-09 Dec-08 Sept-07 Sept-07 Sept-07 Sept-07 Sept-07 Vermox (B) Cycrin Cycrin Cycrin (B) (B) 1% Oct-06 (B)

MEGLUMINE DIATRIZOATE WITH SODIUM AMIDOTRIZOATE Oral soln 660 mg per ml with sodium amidotrizoate 100 mg per ml, 100 ml ..................................... Gastrografin

190.00

Mar-07

Gastroview 120 ml

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST)

DV Limit

DV Limit applies from

DV Pharmaceuticals

MEGLUMINE GADOPENTETATE Inj 469 mg per ml (equivalent to 0.5 mmol per ml), 10 ml prefilled syringe ................................................ Inj 469 mg per ml (equivalent to 0.5 mmol per ml), 20 ml ......................

Magnevist

84.64

Mar-07

Dotarem Omniscan 5 ml & 10 ml Dotarem 15 ml & 20 ml Omniscan 15 ml & 20 ml (B) (B) Asacol

Magnevist

33.85

Mar-07

MEROPENEM Inj 500 mg................................................ Inj 1 g....................................................... MESALAZINE Enema 1 g per 100 ml .............................. Suppos 500 mg........................................ Suppos 1 g............................................... Tab 400 mg.............................................. MESNA Inj 100 mg per ml, 4 ml ............................ Inj 100 mg per ml, 10 ml .......................... Tab 400 mg.............................................. Tab 600 mg.............................................. METFORMIN HYDROCHLORIDE Tab 500 mg..............................................

Merrem Merrem Pentasa Asacol Pentasa Asacol Uromitexan Uromitexan Uromitexan Uromitexan

255.00 505.00 46.90 25.20 50.96 49.50 109.63 251.73 168.30 251.35

10 10 7 20 28 100 15 15 50 50 500

1% 1% 1%

Sept-08 Sept-08 Sept-06

1% 1%

Oct-07 Oct-07

(B) (B)

Arrow-Metformin 9.75

Oct-07

Tab 850 mg..............................................

Arrow-Metformin 8.00

250

Oct-07

3M Metformin Apo-Metformin Glucomet Metomin 3M Metformin Apo-Metformin Glucomet Metomin Pallidone

METHADONE HYDROCHLORIDE Tab 5 mg.................................................. Oral liq 2 mg per ml .................................. Oral liq 5 mg per ml .................................. Oral liq 10 mg per ml ................................ Inj 10 mg per ml, 1 ml .............................. METHOTREXATE Inj 100 mg per ml, 10 ml .......................... Inj 100 mg per ml, 50 ml .......................... Tab 2.5 mg............................................... Tab 10 mg................................................

Methatabs Biodone Biodone Forte Biodone Extra Forte AFT Methotrexate Ebewe Methotrexate Ebewe Methoblastin Methoblastin

2.10 6.55 6.52 9.50 52.00 27.50 135.00 5.80 40.93

10 1% 200 ml 200 ml 200 ml 10 1 1 30 50 1% 1% 1% 1%

Nov-07

Nov-08 Nov-08 Sept-06 Sept-06

Hospira Hospira Emthexate Mayne Emthexate Mayne

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 10.00 14.00 12.00 13.10 20.85 3.20 4.29 7.85 10.95 58.96 65.44 71.93 86.24 48.57 166.52 4.95 4.95 6.03 25 g 100 g 100 100 100 30 30 30 30 30 30 30 30 100 20 15 g 15 g 1

DV Limit

DV Limit applies from

DV Pharmaceuticals

METHYL HYDROXYBENZOATE Powder .................................................... METHYLCELLULOSE Powder .................................................... METHYLDOPA Tab 125 mg.............................................. Tab 250 mg.............................................. Tab 500 mg.............................................. METHYLPHENIDATE HYDROCHLORIDE Tab 5 mg.................................................. Tab 10 mg................................................ Tab 20 mg................................................ Tab long-acting 20 mg..............................

ABM ABM Prodopa Prodopa Prodopa Rubifen Rubifen Rubifen Rubifen SR

1% 1% 1% 1% 1% 1% 1%

Dec-08 Dec-08 Dec-08 Jan-07 Oct-06 Jan-07 Jan-07

(B) (B) (B) (B) Ritalin (B) Ritalin SR

METHYLPHENIDATE HYDROCHLORIDE EXTENDED-RELEASE Tablet extended-release 18 mg ................. Concerta Tablet extended-release 27 mg ................. Concerta Tablet extended-release 36 mg ................. Concerta Tablet extended-release 54 mg ................. Concerta METHYLPREDNISOLONE Tab 4 mg.................................................. Tab 100 mg.............................................. METHYLPREDNISOLONE ACEPONATE Crm 0.1% ................................................. Oint 0.1% ................................................. METHYLPREDNISOLONE ACETATE Inj 40 mg per ml, 1 ml .............................. Medrol Medrol Advantan Advantan Depo-Medrol

1% 1% 1% 1% 1%

Sept-06 Sept-06 Sept-06 Sept-06 Sept-08

(B) (B) (B) (B) (B)

METHYLPREDNISOLONE ACETATE WITH LIGNOCAINE Inj 40 mg per ml with lignocaine 10 mg per ml, 1 ml ......... Depo-Medrol 6.03 with Lidocaine METHYLPREDNISOLONE SODIUM SUCCINATE Inj 40 mg per ml, 1 ml .............................. Inj 62.5 mg per ml, 2 ml ........................... Inj 500 mg................................................ Inj 1 g....................................................... METOCLOPRAMIDE HYDROCHLORIDE Tab 10 mg................................................ Inj 5 mg per ml, 2 ml ................................ Solu-Medrol Solu-Medrol Solu-Medrol Solu-Medrol Metamide Pfizer 151.40 412.59 16.45 42.57 5.15 4.50

Sept-08

(B)

25 25 1 1 100 10

1% 1%

Sept-06 Sept-06

Mayne Mayne

Sept-08

Metoclopramide Astra Maxolon (B)

METOPROLOL TARTRATE Tab long-acting 200 mg............................

Slow-Lopresor

18.40

Sept-06

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 12.30 9.50 17.50 25.00 24.48 0.42 5 100 100 100 ml 10 15 g

DV Limit

DV Limit applies from Sept-08

DV Pharmaceuticals

METRONIDAZOLE Inj 500 mg, 100 ml ................................... Tab 200 mg ............................................. Tab 400 mg.............................................. Oral liq 200 mg per 5 ml ........................... Suppos 500 mg........................................ MICONAZOLE NITRATE Crm 2% ....................................................

AFT Trichozole Trichozole Flagyl-S Flagyl Multichem

Baxter Pfizer

Sept-08

AFT Daktarin Fungo Micreme Tinasolve Resolve

Powder 2% .............................................. MIDAZOLAM Inj 1 mg per ml, 5 ml ................................ Inj 5 mg per ml, 3 ml ................................ MITOZANTRONE Inj 2 mg per ml, 5 ml ................................ Inj 2 mg per ml, 10 ml .............................. Inj 2 mg per ml, 12.5 ml ........................... MIVACURIUM Inj 10 mg per 5 ml .................................... Inj 20 mg per 10 ml .................................. MOMETASONE FUROATE Crm 0.1% ................................................. Crm 0.1% ................................................. Oint 0.1% ................................................. Oint 0.1% ................................................. Lotn 0.1%................................................. MORPHINE HYDROCHLORIDE Oral liq 1 mg per ml .................................. Oral liq 2 mg per ml .................................. Oral liq 5 mg per ml .................................. Oral liq 10 mg per ml ................................

Daktarin Hypnovel Hypnovel Mitozantrone Ebewe Mitozantrone Ebewe Onkotrone Mivacron Mivacron Elocon Elocon Elocon Elocon Elocon RA-Morph RA-Morph RA-Morph RA-Morph

8.50 10.75 11.90 110.00 220.00 407.50 33.92 67.17 3.96 10.82 3.96 10.82 4.80 8.06 8.56 9.61 12.56

30 g 10 5 1 1 1 5 5 15 g 45 g 15 g 45 g 30 ml 200 ml 200 ml 200 ml 200 ml 1% 1% 1% 1% Nov-06 Nov-06 Nov-06 Nov-06 (B) (B) (B) (B) 5% 5% 1% 1% Apr-06 Apr-06 Feb-08 Feb-08 Mayne Mayne Onkotrone Mayne Novatrone Onkotrone

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 1.80 2.64 7.20 7.85 17.00 2.64 5.10 34.50 75.00 59.50 95.00 5.17 4.50 4.70 4.98 20.20 67.37 5.72 133.33 206.66 206.66 285.00 14.97 22.19 33.00 180.00 6.00 20.30 134.55 10 10 10 10 10 10 10 10 10 10 10 5 5 5 5 5 5 325 g 4 100 50 165 ml 100 100 5 30 120 50

DV Limit

DV Limit applies from Sept-06 Sept-06 Sept-06 Sept-06 Sept-06 Sept-06 Sept-06 Jan-09 Jan-09 Jan-09 Jan-09 Oct-06 Aug-08 Oct-06 Aug-08

DV Pharmaceuticals

MORPHINE SULPHATE Cap long-acting 10 mg ............................. Cap long-acting 30 mg ............................. Cap long-acting 60 mg ............................. Cap long-acting 100 mg ........................... Cap long-acting 200 mg ........................... Tab immediate release 10 mg ................... Tab immediate release 20 mg ................... Inj 1 mg per ml, 10 ml prefilled syringe.................................... Inj 1 mg per ml, 30 ml prefilled syringe.................................... Inj 1 mg per ml, 50 ml prefilled syringe.................................... Inj 2 mg per ml, 30 ml prefilled syringe.................................... Inj 5 mg per ml, 1 ml ................................ Inj 10 mg per ml, 1 ml .............................. Inj 15 mg per ml, 1 ml .............................. Inj 30 mg per ml, 1 ml .............................. MORPHINE TARTRATE Inj 80 mg per ml, 1.5 ml ........................... Inj 80 mg per ml, 5 ml .............................. MUCILAGINOUS LAXATIVES Dry ........................................................... MYCOPHENOLATE MOFETIL Inj 500 mg vial ......................................... Cap 250 mg ............................................ Tab 500 mg.............................................. Pwd oral liq 1 g per 5 ml ........................... NADOLOL Tab 40 mg................................................ Tab 80 mg................................................ NALOXONE HYDROCHLORIDE Inj 400 µg per ml, 1 ml ............................. NALTREXONE HYDROCHLORIDE Tab 50 mg................................................ NAPROXEN SODIUM Tab 275 mg.............................................. NEOSTIGMINE METHYLSULPHATE Inj 2.5 mg per ml, 1 ml ............................. NEVIRAPINE Oral suspension 10 mg per ml ..................

m-Eslon m-Eslon m-Eslon m-Eslon m-Eslon Sevredol Sevredol Biomed Biomed Biomed Biomed Mayne Mayne Mayne Mayne Mayne Mayne Konsyl-D CellCept CellCept CellCept CellCept Apo-Nadolol Apo-Nadolol Mayne ReVia Sonaflam AstraZeneca Viramune Suspension

1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1% 1%

Kapanol Kapanol Kapanol Kapanol Kapanol (B) (B) Baxter Baxter Baxter Baxter (B) (B) (B) (B)

Oct-06

(B)

1% 1%

Sept-07 Sept-07

Corgard Corgard

1% 1% 1%

Sept-07 Feb-08 Sept-07 Nov-06

(B) Synflex (B) (B)

240 ml 1%

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 14.97 14.97 20.02 20.02 11.08 11.08 10.53 11.63 12.32 96 96 96 96 36 36 7 7 7

DV Limit

DV Limit applies from Apr-08 Apr-08 Apr-08 Apr-08

DV Pharmaceuticals

NICOTINE Gum 2 mg (mint) ...................................... Gum 2 mg (fruit)....................................... Gum 4 mg (mint) ...................................... Gum 4 mg (fruit)....................................... Lozenge 1 mg .......................................... Lozenge 2 mg .......................................... Patch 7 mg............................................... Patch 14 mg............................................. Patch 21 mg............................................. NIFEDIPINE Tab long-acting 20 mg.............................. Tab long-acting 30 mg.............................. Tab long-acting 60 mg..............................

Habitrol Habitrol Habitrol Habitrol Habitrol Habitrol Habitrol Habitrol Habitrol

10% 10% 10% 10%

Nicorette Nicotinell Nicotrol Nicorette Nicotinell Nicotrol Nicorette Nicotinell Nicotrol Nicorette Nicotinell Nicotrol Nicorette Nicotrol Nicorette Nicotrol Nicorette Nicotrol (B)

10% 10% 10%

Apr-08 Apr-08 Apr-08

Nyefax Retard 7.30 Arrow-Nifedipine 10.70 XR Adefin XL Arrow-Nifedipine 15.35 XR Adefin XL Levophed Primolut N ArrowNorfloxacin Norpress Norpress Nilstat Nilstat Nilstat 42.00 25.00 22.50 5.94 20.06 11.64 9.60 3.19

100 30 30

Nov-06

NORADRENALINE ACID TARTRATE Inj 1:1,000 per 2 ml .................................. NORETHISTERONE Tab 5 mg.................................................. NORFLOXACIN Tab 400 mg.............................................. NORTRIPTYLINE HYDROCHLORIDE Tab 10 mg................................................ Tab 25mg................................................. NYSTATIN Cap 500,000 u ......................................... Tab 500,000 u.......................................... Oral liq 100,000 u per ml ..........................

6 100 100 100 250 50 50 24 ml 1% 1% 1% 1% 1% Dec-08 Dec-08 Sept-07 Sept-07 Dec-08 (B) (B) (B) Mycostatin (B) 1% Sept-08 (B)

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 25.65 39.15 48.50 72.90 175.00 359.10 1,772.50 2,358.75 2,951.25 5 5 5 5 5 5 1 1 1

DV Limit

DV Limit applies from

DV Pharmaceuticals

OCTREOTIDE Inj 50 µg per ml, 1 ml ............................... Inj 100 µg per ml, 1 ml ............................ Inj 500 µg per ml, 1 ml ............................ Inj LAR, 10 mg prefilled syringe ................ Inj LAR, 20 mg prefilled syringe ................ Inj LAR, 30 mg prefilled syringe ................ OLANZAPINE Tab 2.5 mg............................................... Tab 5 mg.................................................. Tab 10 mg................................................ Wafer 5 mg .............................................. Wafer 10 mg ............................................ OMEPRAZOLE Cap 10 mg ..............................................

Hospira Sandostatin Hospira Sandostatin Hospira Sandostatin Sandostatin LAR Sandostatin LAR Sandostatin LAR Zyprexa Zyprexa Zyprexa Zyprexa Zydis Zyprexa Zydis

51.07 101.21 204.49 102.19 204.37 2.00 2.14 4.40 2.85 3.05 4.70 3.35 3.59 5.90 7.73 38.20 38.65 38.65

28 28 28 28 28 28 30 30 28 30 30 28 30 30 1 5 5 5

Dr Reddy’s Omeprazole Dr Reddy’s Omeprazole Losec Cap 20 mg .............................................. Dr Reddy’s Omeprazole Dr Reddy’s Omeprazole Losec Cap 40 mg .............................................. Dr Reddy’s Omeprazole Dr Reddy’s Omeprazole Losec Inj 40 mg.................................................. Losec IV Dr Reddy’s Omeprazole Inf 40 mg ................................................. Dr Reddy’s Omeprazole Losec IV Note – Losec 10 mg, 20 mg and 40 mg to be delisted 1 May 2009 ONDANSETRON HYDROCHLORIDE Tab disp 4 mg .......................................... Tab disp 8 mg .......................................... Tab 4 mg.................................................. Tab 8 mg.................................................. Inj 2 mg per ml, 2 ml ................................ Inj 2 mg per ml, 4 ml ................................ Zofran Zydis Zofran Zydis Zofran Zofran Mayne Zofran Mayne Zofran

17.18 20.43 17.18 33.89 18.00 24.64 29.00 52.79

10 10 10 20 5 5 5 5

1% 1% 1% 1%

Aug-07 Aug-07 Aug-07 Aug-07

(B) (B) (B) (B)

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 200.00 400.00 1 1

DV Limit

DV Limit applies from

DV Pharmaceuticals

OXALIPLATIN Inj 50 mg.................................................. Inj 100 mg................................................ OXYBUTYNIN Oral liq 5 mg per 5 ml ............................... Tab 5 mg.................................................. OXYCODONE HYDROCHLORIDE Inj 10 mg per ml, 1 ml .............................. Inj 10 mg per ml, 2 ml .............................. Oral liq 5 mg per 5 ml ............................... Cap 5 mg ................................................. Cap 10 mg ............................................... Cap 20 mg ............................................... Tab controlled-release 5 mg ..................... Tab controlled-release 10 mg ................... Tab controlled-release 20 mg ................... Tab controlled-release 40 mg ................... Tab controlled-release 80 mg ................... OXYTOCIN Inj 5 iu per ml, 1 ml .................................. Inj 10 iu per ml, 1 ml ................................ OXYTOCIN WITH ERGOMETRINE MALEATE Inj 5 iu with ergometrine maleate 500 µg per ml, 1 ml ......................................... PACLITAXEL Inj 30 mg..................................................

Eloxatin Eloxatin

Apo-Oxybutynin 50.40 Apo-Oxybutynin 44.79 OxyNorm OxyNorm OxyNorm OxyNorm OxyNorm OxyNorm OxyContin OxyContin OxyContin OxyContin OxyContin Syntocinon Syntocinon 14.40 28.80 11.20 2.83 5.58 9.77 7.51 11.14 18.93 33.29 58.03 5.40 6.80

473 ml 1% 500 1% 5 1% 5 1% 250 ml 1% 20 20 20 20 20 20 20 20 5 5 1% 1%

Dec-07 Dec-07 Nov-07 Nov-07 Nov-07

(B) (B) (B) (B) (B)

May-07 May-07

(B) (B)

Syntometrine Paclitaxel Ebewe Paclitaxel Ebewe Paclitaxel Ebewe Paclitaxel Ebewe Paclitaxel Ebewe Paclitaxel Ebewe Pamisol Pamisol Pamisol Pamisol AstraZeneca

9.20 37.95 189.75 125.35 188.03 376.05 724.50

5 1 5 1 1 1 1

1% 1% 1% 1% 1% 1% 1%

May-07 Oct-08 Oct-08 Oct-08 Oct-08 Oct-08 Oct-08

(B) Anzatax Taxol Anzatax Taxol Anzatax Taxol Anzatax Taxol Anzatax Taxol (B)

Inj 100 mg................................................ Inj 150 mg................................................ Inj 300 mg................................................ Inj 600 mg................................................ PAMIDRONATE DISODIUM Inj 3 mg per ml, 5 ml ................................ Inj 3 mg per ml, 10 ml .............................. Inj 6 mg per ml, 10 ml ............................ Inj 9 mg per ml, 10 ml .............................. PANCURONIUM BROMIDE Inj 2 mg per ml, 2 ml ................................

18.75 37.50 75.00 112.50 125.00

1 1 1 1 50

1% 1% 1% 1% 1%

Sept-08 Sept-08 Sept-08 Sept-08 Sept-06

(B) AFT-Pamidronate AFT-Pamidronate AFT-Pamidronate Mayne

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 8.75 2.24 3.36 1 28 28

DV Limit

DV Limit applies from May-09 Mar-08 Mar-08

DV Pharmaceuticals

PANTOPRAZOLE Inj 40 mg.................................................. Tab 20 mg................................................ Tab 40 mg................................................ PAPAVERINE HYDROCHLORIDE Inj 12 mg per ml, 10 ml ............................ PARACETAMOL Oral liquid 120 mg per 5 ml ......................

Pantocid Dr Reddy’s Pantoprazole Dr Reddy’s Pantoprazole Mayne

1% 1% 1%

Somac Somac Somac

73.12

5 1000 ml 20% Sept-08 Amcal Junior Parapaed Pamol Panadol Colourfree Amcal Six Plus Parapaed Pamol PSM (B) (B)

Paracare Junior 6.80

Oral liquid 250 mg per 5 ml ......................

Paracare 7.00 Double Strength

1000 ml 20%

Sept-08

Suppos 25 mg.......................................... Suppos 50 mg.......................................... Suppos 125 mg........................................ Suppos 250 mg........................................ Suppos 500 mg........................................ PAROXETINE HYDROCHLORIDE Tab 20 mg................................................

Biomed Biomed Panadol Panadol Paracare Loxamine

56.35 56.35 6.51 12.52 20.50 5.90

20 20 20 20 50 30

1% 1%

Nov-06 Nov-06

Jul-07

Apo-Paroxetine Aropax Luxotine

PEGFILGRASTIM Inj 6 mg per 0.6 ml prefilled syringe .......... PENICILLAMINE Tab 125 mg.............................................. Tab 250 mg.............................................. PENTASTARCH Inf 6%, 500 ml bag ................................... Inf 10% per 500 ml bag ............................ PERGOLIDE Tab 0.25 mg............................................. Tab 1 mg.................................................. PERHEXILINE MALEATE Tab 100 mg.............................................. PERMETHRIN Crm 5% ....................................................

Neulastim D-Penamine D-Penamine

1,395.00 61.93 98.98

1 100 100 16 16 100 100 100 30 g 10% 1% 1% 1% 1% Nov-06 Sept-08 Sept-08 Sept-08 Dec-06 Voluven Pentaspan (B) (B) Pexcid

StarQuin 200 239.68 6% StarQuin 10% 216.00 Permax Permax Pexsig Lyderm 48.00 170.00 62.90 4.20

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 3.75 4.18 3.00 4.00 4.29 8.15 1.68 1.82 27.50 5 5 10 10 50 50 100 ml 100 ml 5 25

DV Limit

DV Limit applies from

DV Pharmaceuticals

PETHIDINE HYDROCHLORIDE Inj 50 mg per ml, 1 ml .............................. Inj 50 mg per ml, 2 ml .............................. Tab 50 mg................................................ Tab 100 mg.............................................. PHENOXYMETHYLPENICILLIN (PENICILLIN V) Cap potassium salt 250 mg ...................... Cap potassium salt 500 mg ...................... Grans for oral liq 125 mg per 5 ml ............ Grans for oral liq 250 mg per 5 ml ............ PHENTOLAMINE MESYLATE Inj 10 mg per ml, 1 ml .............................. PHENYLEPHRINE HYDROCHLORIDE Inj 1%, 1 ml .............................................. PHYTOMENADIONE Inj 2 mg per 0.2 ml ................................... Inj 10 mg per ml, 1 ml .............................. Tab 10 mg................................................ PIOGLITAZONE Tab 15 mg................................................ Tab 30 mg................................................ Tab 45 mg................................................ PIROXICAM Tab dispersible 10 mg .............................. Tab dispersible 20 mg .............................. PODOPHYLLOTOXIN Soln 0.5%................................................. POLOXAMER Oral drops 10% ........................................

Mayne Mayne PSM PSM Cilicaine VK Cilicaine VK AFT AFT Regitine

1% 1% 1% 1%

Sept-07 Sept-07 Dec-07 Dec-07

(B) (B) (B) (B)

Neosynephrine 115.50 HCL Konakion MM Konakion MM Konakion Actos Actos Actos Piram-D Piram-D Condyline Coloxyl 8.00 9.21 5.60 61.04 93.90 119.18 3.25 5.50 33.60 3.78 13.80 2.95 3.62 3.80 3.88 425.00 695.00 5.20

5 5 10 28 28 28 50 100 3.5 ml 30 ml 4 15 ml 15 ml 15 ml 15 ml 1 1 200 1% Dec-06 Slow-K K-SR 1% Dec-08 (B)

POLYETHYLENE GLYCOL WITH SODIUM SULPHATE Powder, sachets ....................................... Klean-Prep POLYVINYL ALCOHOL Eye drops 1.4% ........................................ Eye drops 3% ........................................... PORACTANT ALFA Inj 80 mg per ml, 1.5 ml ........................... Inj 80 mg per ml, 3 ml .............................. POTASSIUM CHLORIDE Tab long-acting 600 mg............................ Vistil Liquifilm Tears Vistil Forte Liquifilm Forte Curosurf Curosurf Span-K

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST)

DV Limit

DV Limit applies from

DV Pharmaceuticals

POTASSIUM CHLORIDE WITH GLUCOSE Inf 20 mmol.L-1 with 5% glucose, 1,000 ml ..........................

Baxter

3.37

POTASSIUM CHLORIDE WITH GLUCOSE AND SODIUM CHLORIDE Inf 20 mmol.L-1 with 2.5% glucose and 0.45% sodium chloride, 500 ml ................................................. Baxter Inf 20 mmol.L-1 with 4% glucose and 0.18% sodium chloride, 500 ml ................................................. Baxter Inf 20 mmol.L-1 with 4% glucose and 0.18% sodium chloride, 1,000 ml .............................................. Baxter Inf 30 mmol.L-1 with 4% glucose and 0.18% sodium chloride, 1,000 ml .............................................. Baxter POTASSIUM CHLORIDE WITH SODIUM CHLORIDE Inf 20 mmol.L-1 with 0.9% sodium chloride, 1,000 ml ................... Baxter Inf 30 mmol.L-1 with 0.9% sodium chloride, 1,000 ml ................................ Baxter POVIDONE IODINE Alcohol skin preparation 10% with 30% alcohol ......................................... Antiseptic soln 10% .................................. Oint 10% .................................................. PRAZOSIN HYDROCHLORIDE Tab 1 mg.................................................. Tab 2 mg.................................................. Tab 5 mg.................................................. PREDNISOLONE SODIUM PHOSPHATE Oral liq 5 mg per ml .................................. PREDNISONE Tab 1 mg.................................................. Tab 2.5 mg............................................... Tab 5 mg.................................................. Tab 20 mg................................................ PRILOCAINE HYDROCHLORIDE Inj 0.5%, 50 ml ......................................... Inj 2%, 5 ml ..............................................

4.95 3.45 3.37 3.62

1 1 1 1

3.37 2.59

1 1

Betadine Skin Prep Riodine Riodine Betadine Betadine Apo-Prazo Apo-Prazo Apo-Prazo Redipred

8.13 2.95 6.20 6.42 2.88 5.53 7.00 11.70 9.95

500 ml 100 ml 500 ml 500 ml 25 g 100 100 100 30 ml 500 500 500 500 1% 1% 1% 1% Dec-08 Dec-08 Dec-08 Dec-08 Douglas Origen Douglas Origen Douglas Origen Douglas Origen (B) (B) 1% 1% 1% May-08 May-08 May-08 (B) (B) (B)

Apo-Prednisone 10.68 Apo-Prednisone 12.09 Apo-Prednisone 11.09 Apo-Prednisone 29.03

Citanest Citanest

80.00 30.90

5 10

1% 1%

Aug-07 Aug-07

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 50.86 16.85 8.05 2.72 4.44 17.02 5 500 5 50 50 5

DV Limit

DV Limit applies from Dec-08

DV Pharmaceuticals

PROCAINE PENICILLIN Inj 1.5 mega u .......................................... PROCHLORPERAZINE Tab 5 mg.................................................. PROMETHAZINE HYDROCHLORIDE Inj 25 mg per ml, 2 ml .............................. Tab 10 mg................................................ Tab 25 mg................................................ PROPOFOL Inj 1%, 20 ml ...........................................

Cilicaine Antinaus Mayne Allersoothe Allersoothe Diprivan

(B)

1% 1% 1%

Jan-09 Jan-09 Dec-06

Phenergan Phenergan Fresenius InterMed Mayne Recofol Fresenius InterMed Mayne Recofol Fresenius InterMed Mayne Recofol (B) (B)

Inj 1%, 50 ml ...........................................

Diprivan

9.26

Dec-06

Inj 1%, 100 ml ..........................................

Diprivan

15.46

Dec-06

Inj 1%, 50 ml prefilled syringe ................... Inj 2%, 50 ml prefilled syringe ................... PROPRANOLOL Cap long-acting 160 mg ........................... PROPYLENE GLYCOL Liquid ....................................................... QUETIAPINE Tab 25 mg................................................ Tab 100 mg.............................................. Tab 200 mg.............................................. Tab 300 mg.............................................. QUINAPRIL Tab 5 mg.................................................. Tab 10 mg................................................ Tab 20 mg................................................ QUINAPRIL WITH HYDROCHLOROTHIAZIDE Tab 10 mg with hydrochlorothiazide 12.5 mg ................ Tab 20 mg with hydrochlorothiazide 12.5 mg ................

Diprivan Diprivan Cardinol LA ABM Seroquel Quetapel Seroquel Quetapel Seroquel Quetapel Seroquel Quetapel Accupril Accupril Accupril

14.19 15.43 16.90 12.00 46.20 20.62 92.40 41.25 158.76 70.88 267.12 119.25 1.60 1.75 2.35

1 1 100 500 ml 60 90 60 90 60 90 60 90 30 30 30

1% 1%

Dec-06 Dec-06

Accuretic 10 Accuretic 20

3.37 4.57

30 30

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 15.95 34.75 250 500

DV Limit

DV Limit applies from Sept-06 Sept-06

DV Pharmaceuticals

QUININE SULPHATE Tab 200 mg.............................................. Tab 300 mg..............................................

Q 200 Q 300

1% 1%

Apo-Quinine Quinoc-F Quinoc-S Apo-Quinine Quinoc-F Quinoc-S

RANITIDINE HYDROCHLORIDE Inj 25 mg per ml, 2 ml .............................. Oral liq 150 mg per 10 ml ......................... Tab 150 mg.............................................. Tab 300 mg.............................................. RECOMBINANT FACTOR VIII Inj 250 IU ................................................. Inj 500 IU ................................................. Inj 1,000 IU .............................................. Inj 1,500 IU .............................................. Inj 2,000 IU .............................................. REMIFENTANIL HYDROCHLORIDE Inj 1 mg vial ............................................. Inj 2 mg vial ............................................. RETEPLASE Inj 10 iu vial .............................................. RIFABUTIN Cap 150 mg ............................................. RISPERIDONE Microspheres for inj 25 mg ....................... Microspheres for inj 37.5 mg .................... Microspheres for inj 50 mg ....................... Orally-disintegrating tab 0.5 mg ................ Orally-disintegrating tab 1 mg ................... Orally-disintegrating tab 2 mg ................... Oral liq 1 mg per ml .................................. Tab 0.5 mg............................................... Tab 1 mg.................................................. Tab 2 mg.................................................. Tab 3 mg.................................................. Tab 4 mg..................................................

Zantac 8.75 Peptisoothe 7.95 Arrow Ranitidine 7.99 Arrow Ranitidine 10.94 Kogenate FS ReFacto Advate Kogenate FS ReFacto Advate Kogenate FS ReFacto Advate Advate Kogenate FS ReFacto Ultiva Ultiva Rapilysin Mycobutin 250.00 225.00 237.50 500.00 450.00 475.00 1,000.00 900.00 950.00 1,425.00 2,000.00 1,800.00 50.75 101.50 1,850.00 213.19

5 300 ml 1% 250 250 1 1 1 1 1 1 1 1 1 1 1 1 5 5 2 30 1 1 1 28 28 28 30 ml 20 60 60 60 60 60 5% 1%

Jan-08

Zantac

Apr-06 Sept-07

(B) (B)

Risperdal Consta 175.00 Risperdal Consta 230.00 Risperdal Consta 280.00 Risperdal Quicklet 21.42 Risperdal Quicklet 42.84 Risperdal Quicklet 85.71 Risperdal 45.92 Risperdal 5.20 Ridal Ridal 15.60 Risperdal 30.77 Ridal Risperdal 61.53 Ridal Risperdal 92.32 Ridal Risperdal 123.05 Ridal

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 121.27 1,195.00 2,987.00 25.32 31.50 35.70 84 2 1 3 210 105 147 84 84 84 5 5 5 5 5 5 5 5

DV Limit

DV Limit applies from

DV Pharmaceuticals

RITONAVIR Cap 100 mg ............................................. RITUXIMAB Inj 100 mg per 10 ml vial .......................... Inj 500 mg per 50 ml vial .......................... RIZATRIPTAN BENZOATE Wafer 10 mg ........................................... ROPINIROLE HYDROCHLORIDE Tab 0.25 mg............................................. Tab 0.25 mg x 42, 0.5 mg x 42 and 1 mg x 21 ..................................... Tab 0.5 mg x 42, 1 mg x 42 and 2 mg x 63 ..................................... Tab 1 mg.................................................. Tab 2 mg.................................................. Tab 5 mg.................................................. ROPIVACAINE HYDROCHLORIDE Inj 2 mg per ml, 10 ml .............................. Inj 2 mg per ml, 20 ml .............................. Inf 2 mg per ml, 100 ml ............................ Inf 2 mg per ml, 200 ml ............................ Inj 7.5 mg per ml, 10 ml ........................... Inj 7.5 mg per ml, 20 ml ........................... Inj 10 mg per ml, 10 ml ............................ Inj 10 mg per ml, 20 ml ............................

Norvir Mabthera Mabthera Maxalt Melt Requip Requip Starter Pack

5% 5%

Apr-06 Apr-06

(B) (B)

Requip 122.11 Follow-on Pack Requip 67.20 Requip 101.21 Requip 150.00 Naropin Naropin Naropin Naropin Naropin Naropin Naropin Naropin 19.75 33.20 104.00 184.00 35.00 62.45 41.10 74.20

1% 1% 1% 1% 1% 1% 1% 1%

Aug-07 Aug-07 Aug-07 Aug-07 Aug-07 Aug-07 Aug-07 Aug-07

(B) (B) (B) (B) (B) (B) (B) (B)

ROPIVACAINE HYDRCHLORIDE WITH FENTANYL Inf 2 mg per ml with 2 µg of fentanyl per ml, 100 ml ..................................... Naropin Inf 2 mg per ml with 2 µg of fentanyl per ml, 200 ml ..................................... Naropin ROXITHROMYCIN Tab 150 mg.............................................. Tab 300 mg..............................................

145.20 262.60

5 5

1% 1%

Aug-07 Aug-07

(B) (B)

ArrowRoxithromycin 9.50 ArrowRoxithromycin 18.00

50 50

1% 1%

May-07 May-07

Romicin Rulide Romicin Rulide

SALBUTAMOL Inhaler 100 µg dose, 200 doses ............... Aerosol inhaler 100 µg per dose, CFC-free ..................................... Nebuliser soln, 1 mg per ml, 2.5 ml .................................................. Nebuliser soln, 2 mg per ml, 2.5 ml .................................................. Oral liq 2 mg per 5 ml ...............................

Ventolin Salamol Asthalin Asthalin Salapin

6.00 4.00 3.70 3.85 2.25

1 200 doses 20 1% Jul-07 Jul-07 Sept-07 (B) (B) Ventolin

20 1% 150 ml 1%

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST)

DV Limit

DV Limit applies from

DV Pharmaceuticals

SALBUTAMOL WITH IPRATROPIUM BROMIDE Aerosol inhaler, 100 µg with ipratropium bromide, 20 µg per dose ........ SALICYLIC ACID Powder .................................................... SALMETEROL Aerosol inhaler CFC-free 25 µg per dose .............................................. Powder for inhalation, breath activated 50 µg per dose.......................... SAQUNAVIR Tab 500 mg.............................................. SEVOFLURANE Liq 250 ml bottle ...................................... SIMVASTATIN Tab 10 mg................................................ Tab 20 mg................................................ Tab 40 mg................................................ Tab 80 mg................................................

Combivent ABM

13.50 15.00

200 dose 500 g

Serevent Serevent Accuhaler Invirase Abbott Sevorane SimvaRex Arrow-Simva SimvaRex Arrow-Simva SimvaRex Arrow-Simva SimvaRex Arrow-Simva

26.46 26.46

120 dose 60 dose

556.59 325.88

120 250 ml 1% Jan-07 Baxter

1.27 2.05 1.54 3.00 2.74 5.35 3.18 11.65

30 90 30 90 30 90 30 90

1% 1% 1% 1%

May-09 May-09 May-09 May-09

Lipex SimvaRex Lipex SimvaRex Lipex SimvaRex

Lipex SimvaRex Note – the SimvaRex brand of simvastatin tabs 10 mg, 20 mg, 40 mg and 80 mg will be delisted from 1 May 2009 SIROLIMUS Tab 1 mg.................................................. Tab 2 mg.................................................. Oral liq 1 mg per ml .................................. SODIUM ACID PHOSPHATE Enema 16% with sodium phosphate 8% ...................................... SODIUM ALGINATE Oral liq 500 mg with sodium bicarbonate 267 mg and calcium carbonate 160 mg per 10 ml .............................................. Rapamune Rapamune Rapamune 813.00 1,626.00 487.80 100 100 60 ml

Fleet Phosphate Enema

2.50

Acidex

4.95

500 ml

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 19.95 20.50 9.80 11.99 19.06 3.92 8.77 8.77 7.86 2.87 2.19 3.07 1.75 1.78 4.91 26.50 20.00 1.75 1.78 3.85 8.09 5.80 4.54 1 1 500 g 500 g 1 1 50 50 20 1 1 1 1 1 1 5 30 ml 1 1 1 1 1 1

DV Limit

DV Limit applies from

DV Pharmaceuticals

SODIUM BICARBONATE Inj 8.4%, 50 ml ......................................... Inj 8.4%, 100 ml ....................................... Powder BP ............................................... Inf 5%, 500 ml .......................................... SODIUM CHLORIDE Inf 0.45%, 500 ml ..................................... Inj 0.9% per 5 ml ...................................... Inj 0.9% per 10 ml .................................... Inj 0.9% per 20 ml .................................... Inf 0.9%, 50 ml ......................................... Inf 0.9%,100 ml ........................................ Inf 0.9%, 250 ml ....................................... Inf 0.9%, 500 ml ....................................... Inf 0.9%, 1,000 ml .................................... Inf 3%, 1,000 ml ....................................... Inj 23.4%, 20 ml ....................................... Soln 0.9% for irrigation ............................. SODIUM CHLORIDE WITH GLUCOSE Inf 0.18%, with glucose 4%, 500 ml .......... Inf 0.18%, with glucose 4%, 1,000 ml ....... Inf 0.45%, with glucose 2.5%, 500 ml ....... Inf 0.45%, with glucose 5%, 500 ml .......... Inf 0.45%, with glucose 5%, 1,000 ml ....... Inf 0.9%, with glucose 5%, 1,000 ml .........

Biomed Biomed ABM Biomed Baxter Baxter AstraZeneca AstraZeneca Multichem Baxter Baxter Baxter Baxter Baxter Baxter Biomed Pfizer Baxter Baxter Baxter Baxter Baxter Baxter

1% 1%

Sept-06 Sept-06

Pharmacia Pharmacia

1% 1%

Dec-06 Nov 08

(B) Orion

SODIUM CITRATE WITH SODIUM LAURYL SULPHOACETATE Enema 90 mg with sodium lauryl sulphoacetate 9 mg per ml, 5 ml .......... Microlax SODIUM CITRO-TARTRATE Gran eff 4 g sachets ................................. SODIUM DIOTRIZOATE Powder for oral soln 3.705 g, 10 ml sachet ........................................ SODIUM HYALURONATE Inj 10 mg per ml, 0.35 ml; and inj 30 mg per ml with chondroitin sulphate 40 mg per ml, 0.4 ml ........................... Inj 10 mg per ml, 0.5 ml; and inj 30 mg per ml with chondroitin sulphate 40 mg per ml, 0.55 ml ......................... Ophthalmic inj 14 mg per ml ..................... Ophthalmic soln 10 mg per ml .................. SOTALOL Tab 80 mg................................................ Tab 160 mg.............................................. Ural

7.30 2.75

12 28 1% Sept-07 Citravescent

Ioscan

149.50

Duovisc Duovisc Healon GV Healon Clear Pacific Pacific

64.00 74.00 50.00 35.00 27.50 10.50

0.75 ml 1% 1.05 ml 1% 1 1% 0.85 ml 1% 500 100

Oct-06 Oct-06 Oct-06 Oct-06

(B) (B) (B) Provisc

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 17.50 8.50 21.70 26.80 117.70 188.10 6.50 12.00 12.00 12.00 12.00 5 100 100 25 ml 1 1 100 g 4 4 2 2 100 g 200 g

DV Limit

DV Limit applies from

DV Pharmaceuticals

SPECIAL FOOD SUPPLEMENT Powder, sachet 74 g................................. SPIRONOLACTONE Tab 25 mg................................................ Tab 100 mg.............................................. Oral liq 5 mg per ml .................................. STREPTOKINASE Inj 250,000 IU .......................................... Inj 1,500,000 IU ....................................... SULPHUR Precipitated .............................................. SUMATRIPTAN Tab 50 mg................................................ Tab 100 mg..............................................

Oral Impact Spirotone Spirotone Biomed Streptase Streptase ABM ArrowSumatriptan Sumagran ArrowSumatriptan Sumagran

1% 1%

Dec-08 Dec-08

(B) (B)

SUNSCREENS, PROPRIETARY Lotn ......................................................... Lotn ......................................................... SUXAMETHONIUM CHLORIDE Inj 50 mg per ml, 2 ml .............................. SYRUP (PHARMACEUTICAL GRADE) Liq ........................................................... TACROLIMUS Cap 0.5 mg .............................................. Cap 1 mg ................................................. Cap 5 mg ................................................. TAMOXIFEN CITRATE Tab 10 mg................................................ Tab 20 mg................................................

Marine Blue 2.55 Lotion SPF 30+ Marine Blue 5.10 Lotion SPF 30+ AstraZeneca Midwest Prograf Prograf Prograf Genox Genox 95.00 21.75 214.00 428.00 1,070.00 9.00 9.25

Aug-07 Sept-07

(B) David Craig

2,000 ml 1% 100 100 50 100 100

TAR WITH TRIETHANOLAMINE LAURYL SULPHATE AND FLUORESCEIN Soln 2.3% with triethanolamine lauryl sulphate and fluorescein sodium ................................................ Pinetarsol 2.90 Pinetarsol 5.45 TEMAZEPAM Tab 10 mg................................................ Normison 0.83

500 ml 1% 1000 ml 25 1%

Dec-08

(B)

Dec-08

(B)

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 50.00 170.00 840.00 2,100.00 531.00 5 5 5 5 30 100

DV Limit

DV Limit applies from

DV Pharmaceuticals

TEMOZOLOMIDE Cap 5 mg ................................................. Cap 20 mg ............................................... Cap 100 mg ............................................. Cap 250 mg ............................................. TENOFOVIR DISOPROXIL FUMARATE Tab 300 mg.............................................. TERBINAFINE Tab 250 mg..............................................

Temodal Temodal Temodal Temodal Viread

Apo-Terbinafine 25.50

Sept-08

Arrow Lamisil Terbinafin Terbinafine-DP (B)

TERLIPRESSIN Inj 1 mg.................................................... TESTOSTERONE Transdermal patch, 2.5 mg per day........... TESTOSTERONE CYPIONATE Inj long-acting 100 mg per ml, 10 ml ........ TETRACOSACTRIN Inj 250 µg ................................................ Inj 1 mg per ml, 1ml ................................. TIOTROPIUM BROMIDE Powder for inhalation 18 µg per dose ...................................... TIROFIBAN HYDROCHLORIDE Inj 0.25 mg per ml, 50 ml ......................... TOBRAMYCIN Inj 40 mg per ml, 2 ml .............................. TOLBUTAMIDE Tab 500 mg.............................................. TOPIRAMATE Tab 25 mg................................................ Tab 50 mg................................................ Tab 100 mg.............................................. Tab 200 mg.............................................. Sprinkle cap 15 mg................................... Sprinkle cap 25 mg...................................

Glypressin Androderm

450.00 80.00

5 60 1

Dec-08

Depo61.41 Testosterone Synacthen 177.18 Synacthen Depot 26.88

Sept-08

(B)

10 1

1% 1%

Sept-08 Sept-08

(B) (B)

Spiriva Aggrastat Mayne Diatol Topamax Topamax Topamax Topamax Topamax Topamax

70.00 370.00 27.50 12.00 26.04 44.26 75.25 129.85 20.84 26.04

30 monodoses 1 5 100 60 60 60 60 60 60

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 2.80 5.60 8.40 11.20 4.50 4.50 124.73 49.14 1,350.00 3,875.00 435.90 11.11 10.31 29.09 23.44 4.38 6.63 6.69 20 20 20 20 5 5 10 100 1 1 100 5 1 5 1 5g 100 g 100 g

DV Limit

DV Limit applies from

DV Pharmaceuticals

TRAMADOL HYDROCHLORIDE Cap 50 mg ............................................... Tab sustained release 100 mg .................. Tab sustained release 150 mg .................. Tab sustained release 200 mg .................. Inj 50 mg per ml, 1 ml .............................. Inj 50 mg per ml, 2 ml .............................. TRANEXAMIC ACID Inj 100 mg per ml, 5ml ............................. Tab 500 mg.............................................. TRASTUZUMAB Inj 150 mg vial.......................................... Inj 440 mg vial.......................................... TRETINOIN Cap 10 mg ............................................... TRIAMCINOLONE ACETONIDE Inj 10 mg per ml, 1 ml .............................. Inj 10 mg per ml, 5 ml .............................. Inj 40 mg per ml, 1 ml .............................. Inj 40 mg per ml, 5 ml .............................. 0.1% in dental paste USP .......................... Crm 0.02% ............................................... Oint 0.02% ...............................................

Tramal Tramal Retard Tramal Retard Tramal Retard Tramal 50 Tramal 100 Cyklokapron Cyklokapron Herceptin Herceptin Vesanoid Kenacort-A Kenacort-A Kenacort-A40 Kenacort-A40 Oracort Aristocort Aristocort

Nov-06

(B)

1% 1% 1% 1%

Dec-08 Sept-08 Dec-08 Dec-08

Baxter Kenalog in Orabase (B) (B)

TRIAMCINOLONE ACETONIDE WITH GRAMICIDIN, NEOMYCIN AND NYSTATIN Ear drops 1 mg with nystatin 100,000 u, neomycin sulphate 2.5 mg and gramicidin 250 µg per g .................................................... Kenacomb 3.35 7.5 ml 1% TRIAMTERENE WITH HYDROCHLOROTHIAZIDE Tab 50 mg with hydrochlorothiazide 25 mg ................... Triamizide TRIMETHOPRIM Tab 300 mg.............................................. TROPISETRON Cap 5 mg ................................................. Inj 1 mg per ml, 2 ml ................................ Inj 1 mg per ml, 5 ml ................................ URSODEOXYCHOLIC ACID Cap 300 mg ............................................. VANCOMYCIN HYDROCHLORIDE Inj 50 mg per ml, 10 ml ............................ TMP Navoban Navoban Navoban Actigall Pacific

Feb-07

(B)

5.00 8.69 77.41 19.20 38.40 179.00 5.04

100 50 5 1 1 100 1 1% 1% Dec-08 Sept-06 (B) (B)

1% 1%

Sept-08 Dec-08

(B) Hospira

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST) 18.64 37.27 45.68 4.75 7.01 11.74 25.00 7.54 137.50 99.00 199.00 42.00 210.00 28 28 28 100 100 100 250 5 5 5 5 1 1

DV Limit

DV Limit applies from

DV Pharmaceuticals

VENLAFAXINE Cap 37.5 mg ............................................ Cap 75 mg ............................................... Cap 150 mg ............................................. VERAPAMIL HYDROCHLORIDE Tab 40 mg................................................ Tab 80 mg................................................ Tab long-acting 240 mg............................ Inj 2.5 mg per ml, 2 ml ............................. VINBLASTINE SULPHATE Inj 10 mg.................................................. VINCRISTINE SULPHATE Inj 1 mg per ml, 1 ml ................................ Inj 1 mg per ml, 2 ml ................................ VINORELBINE Inj 10 mg per ml, 1 ml .............................. Inj 10 mg per ml, 5 ml .............................. WATER Inf 1,000 ml ............................................. Purified for inj 5 ml ................................... Purified for inj 10 ml ................................. Purified for inj 20 ml .................................

Efexor XR Efexor XR Efexor XR Verpamil Isoptin Isoptin Verpamil SR Isoptin Mayne Mayne Mayne Vinorelbine Ebewe Vinorelbine Ebewe Baxter Multichem Multichem Multichem

1% 1% 1% 1%

Aug-06 Aug-06 Jan-07 Jan-07

(B) (B) Mayne Navelbine Mayne Navelbine

3.54 9.31 10.38 5.04

1 50 50 20

1% 1% 1%

Feb-07 Feb-07 Mar-07

Pharmacia Pharmacia Pharmacia

WATER WITH SODIUM, POTASSIUM, CALCIUM, BICARBONATE AND CHLORIDE Inf 131 mmol.L-1 sodium, 5 mmol.L-1 potassium, 2 mmol.L-1 calcium, 29 mmol.L-1 bicarbonate and 111 mmol.L-1 chloride, 500 ml ............. Baxter 1.75 1 Inf 131 mmol.L-1 sodium, 5 mmol.L-1 potassium, 2 mmol.L-1 calcium, 29 mmol.L-1 bicarbonate and 111 mmol.L-1 chloride, 1,000 ml .......... Baxter 1.78 1 WATER WITH SODIUM, POTASSIUM, CALCIUM, BICARBONATE, CHLORIDE AND GLUCOSE Inf 131 mmol.L-1 sodium, 5 mmol.L-1 potassium, 2 mmol.L-1 calcium, 29 mmol.L-1 bicarbonate 111 mmol.L-1 chloride and glucose 5%, 1,000 ml .......................... Baxter 5.38 1 WATER WITH SODIUM, POTASSIUM, CALCIUM AND CHLORIDE Inf 147 mmol.L-1 sodium, 4 mmol.L-1 potassium, 2.2 mmol.L-1 calcium and 156 mmol.L-1 chloride, 1,000 ml.... Baxter

4.43

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Contracted Pharmaceutical Description

Brand

Price ($) Per (ex man. excl. GST)

DV Limit

DV Limit applies from

DV Pharmaceuticals

WATER WITH SODIUM, POTASSIUM, MAGNESIUM, CHLORIDE, ACETATE AND GLUCONATE Inf 140 mmol.L-1 sodium, 5 mmol.L-1 potassium, 1.5 mmol.L-1 magnesium, 98 mmol.L-1 chloride, 27 mmol.L-1 acetate and 23 mmol.L-1 gluconate, 500 ml ................................ Baxter 2.95 1 Inf 140 mmol.L-1 sodium, 5 mmol.L-1 potassium, 1.5 mmol.L-1 magnesium, 98 mmol.L-1 chloride, 27 mmol.L-1 acetate and 23 mmol.L-1 gluconate, 1,000 ml ............................. Baxter 3.00 1 ZINC AND CASTOR OIL Ointment ................................................. Orion 1.20 20 g 1% Sept-06 Douglas PSM M&C Care and Health Midwest Multichem Sigma

Note - Pack sizes larger than 30 g are not considered DV Pharamceuticals. ZINC SULPHATE Cap 220 mg ............................................. ZIPRASIDONE Cap 20 mg ............................................... Cap 40 mg ............................................... Cap 60 mg ............................................... Cap 80 mg ............................................... ZOLEDRONIC ACID Soln for Inf 4 mg, 5 ml .............................. ZOPICLONE Tab 7.5 mg............................................... ZUCLOPENTHIXOL DECANOATE Depot inj 200 mg per ml, 1 ml .................. Zincaps Zeldox Zeldox Zeldox Zeldox Zometa Apo-Zopiclone Clopixol 10.00 87.88 164.78 247.17 329.56 550.00 21.02 19.80 100 60 60 60 60 1 500 5 1% Feb-09 Imovane 1% Dec-08 (B)

Products with Hospital Supply Status (HSS) are in bold.

(B) – Subject only to part (b) of the definition of “DV Pharmaceutical”

Part III – Hospital Pharmaceuticals Assessed by PHARMAC

To obtain a copy of the summary discussion documents, please contact either Rachel Grocott (04 916 7535; rachel.grocott@pharmac.govt.nz) or Ginny Priest (04 916 7568; ginny.priest@pharmac.govt.nz)

Assessments in 2006

Status of Assessment Draft version distributed N/A in June 2006 Cost/QALY Result Value for Money? Recommendations The three fibrin-specific Hospitals should contract for the fibrin-specific bolus thrombolytics are similar thrombolytic (i.e reteplase or tenecteplase) that can be in terms of efficacy and purchased at least cost. safety profiles. The costs of administration and monitoring of the two drugs are comparable. Bevacizumab is cost-saving Bevacizumab appears to be a relatively cost-effective compared with verteporfin treatment for exudative ARMD. treatment. However, it should be noted that this is both an Bevacizumab is also unapproved indication and route of administration for cost-saving compared bevacizumab. Therefore any use of bevacizumab must with placebo in patients comply with Section 25 of the Medicines Act 1981. with poor initial visual acuity (VA) (<20/100 on the Snellen VA scale), and moderately cost-effective (cost/QALY $10,000$15,000) in patients with better initial VA (20/40 on the Snellen VA scale).

Pharmaceutical Comparator

Indication(s) Assessed

Tenecteplase (Metalyse)

Other fibrinspecific thrombolytics (alteplase and reteplase)

ST-elevated myocardial infarction.

Bevacizumab (Avastin) Draft version distributed Cost-saving to $15,000/ in September 2006. QALY.

Standard treatment (verteporfin photodynamic therapy/ placebo)

Exudative age-related macular degeneration (ARMD).

Part III – Hospital Pharmaceuticals Assessed by PHARMAC

To obtain a copy of the summary discussion documents, please contact either Rachel Grocott (04 916 7535; rachel.grocott@pharmac.govt.nz) or Ginny Priest (04 916 7568; ginny.priest@pharmac.govt.nz)

Assessments in 2005

Status of Assessment Final version distributed $191,000/QALY in February 2005. At current price, not very good value for money. Cost/QALY Result Value for Money? Recommendations Another TNF-inhibitor - adalimumab (Humira) is now funded for use in the community under Special Authority criteria. Hospital funding should be restricted to patients who would meet the Special Authority criteria for funding in the community to allow continuation of care upon discharge.

Pharmaceutical Comparator

Indication(s) Assessed

TNF-alpha inhibitors etanercept (Enbrel), infliximab (Remicade) and adalimumab (Humira) Final version distributed $9,000/QALY when used in in September 2005. non-compliant patients. Cost-saving for patients on a Community Treatment Order.

Methotrexate

Rheumatoid arthritis.

Risperidone microspheres (Risperdal Consta)

Partial adherence with oral olanzapine or oral risperidone Distributed in June 2005. Cost-minimisation indicated Unlikely to be good value increase in cost of $240 per for money. patient.

Last-line treatment of schizophrenia.

Hospital funding should be restricted to patients who would meet the Special Authority criteria for funding in the community.

Tirofiban (Aggrastat)

Standard treatment

High-risk patients with acute coronary syndrome.

There is no evidence indicating that treatment with tirofiban is associated with reduced mortality. Absolute risk reductions in myocardial infarctions and refractory ischemic events are small, hence any hospital savings from reduced ischemic events are likely to be modest. The budgetary impact is likely to be significant.

Part III – Hospital Pharmaceuticals Assessed by PHARMAC

To obtain a copy of the summary discussion documents, please contact either Rachel Grocott (04 916 7535; rachel.grocott@pharmac.govt.nz) or Ginny Priest (04 916 7568; ginny.priest@pharmac.govt.nz)

Assessments in 2004

Status of Assessment Final version distributed $60,000/QALY - $220,000/ in February 2004. QALY (depending on risk of GI ulcer). Poor value for money, even when targeted. No net health gains associated with celecoxib compared with diclofenac, or rofecoxib compared with naproxen. Final version distributed N/A in April 2004. Not good value for money for first-line empiric treatment of respiratory infections (costs approximately 12 times more than standard treatment, with no evidence of increased efficacy). Cost/QALY Result Value for Money? Recommendations COX-2 inhibitors provide little (if any) additional clinical benefit over traditional NSAIDs, and at significantly higher cost. Therefore they do not represent good value for money compared with other pharmaceuticals that could be funded.

Pharmaceutical Comparator

Indication(s) Assessed

Celecoxib (Celebrex) and rofecoxib (Vioxx)

Conventional Pain and inflammation NSAIDs in rheumatoid arthritis (diclofenac and osteoarthritis. and naproxen)

Moxifloxacin (Avelox) and gatifloxacin (Tequin)

Standard treatment

Community-acquired respiratory infections.

The new fluoroquinolones should be reserved for last-line treatment of severe community acquired pneumonia (where alternative agents have failed or are contraindicated). Unnecessary use of the new fluoroquinolones in any circumstances other than those specified above may lead to enhanced antibiotic resistance, increased sideeffects and increased costs.

Venlafaxine (Efexor)

Paroxetine

Treatment resistant depression.

Draft version distributed $4,000/QALY in June 2004.

Good value for money when Treatment in hospital should be restricted to patients targeted. who will meet the commuinty Special Authority criteria to allow continuation of treatment upon discharge.

Part III – Hospital Pharmaceuticals Assessed by PHARMAC

To obtain a copy of the summary discussion documents, please contact either Rachel Grocott (04 916 7535; rachel.grocott@pharmac.govt.nz) or Ginny Priest (04 916 7568; ginny.priest@pharmac.govt.nz)

Assessments in 2003

Status of Assessment Final version distributed N/A in November 2003. For day surgery isoflurane is associated with lower costs and similar rates of post-operative nausea and vomiting (PONV) as sevoflurane and desflurane. For major surgery the costs associated with the volatile anaesthetics are very similar (due to shorter postoperative care unit stays for patients administered sevoflurane or desflurane). Final version distributed $35,000/QALY for patients in March 2003. with a high risk of death. $97,000/QALY for all patients with severe sepsis. Less effective and more costly for patients with low risk of death. Final version distributed $3,000-$5,000/QALY for in July 2003. last-line treatment. Good value for money if well targeted. May be reasonable value for money for patients with severe sepsis at high risk of death (APACHE II score ≥ 25). Cost/QALY Result Value for Money? Recommendations Each anaesthetic agent has specific clinical uses. However in cases where more than one agent is suitable it is important that cost-effectiveness is considered. Significant savings can also be made through the use of low gas flows. Compliance with low gas flows could be improved through regular gas flow audits. Cost savings can also be obtained through the choice of the default vaporiser, availability of the different anaesthetics, regular drug expenditure audits, adherence to contract arrangements and prevention of DV limit breeches. Drotrecogin alfa (activated) represents reasonable value for money only if targeted to patients who are most likely to benefit. Drotrecogin alfa (activated) should not be used in patients with severe sepsis at low risk of death (APACHE II score ≤ 24).

Pharmaceutical Comparator

Indication(s) Assessed

Desflurane (Suprane)

Sevoflurane, N/A isoflurane, and propofol

Drotrecogin alfa Placebo activated (Xigris)

Severe sepsis.

Gabapentin (Neurontin)

Placebo

Neuropathic pain for patients who are intolerant or unresponsive to alternative treatments.

Hospital funding should be restricted to patients who would meet the Special Authority criteria for funding in the community to allow continuation of care upon discharge.

Infliximab (Remicade)

Usual care

Moderate to severe Crohn’s disease for patients who are refractory to conventional treatment.

Final version distributed $53,000/QALY for single in November 2002. dose. $118,000/QALY for retreatment. $382,000/QALY for maintenance treatment.

May represent reasonable It is recommended that only a single-dose of infliximab value for money if only a be administered to patients with severe first presentation single-dose is administered. of Crohn’s disease. This may induce remission of disease, and allow patients to be stabilised on Other options represent conventional therapies. poor value for money. Clear treatment guidelines and criteria are recommended in order to avoid overuse or inappropriate use.

Part III – Hospital Pharmaceuticals Assessed by PHARMAC

To obtain a copy of the summary discussion documents, please contact either Rachel Grocott (04 916 7535; rachel.grocott@pharmac.govt.nz) or Ginny Priest (04 916 7568; ginny.priest@pharmac.govt.nz) Value for Money? Cost-saving if patients can be discharged on oral treatment within the first week of hospitalisation. Recommendations For patients who are vancomycin-resistant, unable to be administered intravenous treatment or have not shown any improvement with vancomycin treatment; linezolid may be a useful option. Linezolid should not displace vancomycin as the standard antibiotic in the treatment of MRSA infections. With the emergence of linezolid-resistant strains, it is important that hospitals have strict protocols for the use of linezolid and that susceptibility patterns are closely monitored. Update distributed in October 2003. $800,000/QALY for bone metastases and osteolytic lesions. Most cost-effective if treatment is targeted to patients with HCM where the benefits are greatest. $40,000/QALY for patients with HCM. Providing treatment is targeted to patients with HCM, zoledronic acid may be a useful option for hospitals that have waiting lists for bisphosphonate treatment (due to shorter administration time). Status of Assessment Final version distributed Increase in cost of $1,300 in July 2003. per patient compared to vancomycin. Cost/QALY Result

Assessments in 2003 continued

Pharmaceutical Comparator

Indication(s) Assessed

Linezolid (Zyvox)

Vancomycin

Methicillin-resistant staphylococcus aureus (MRSA) infections.

Zoledronic acid (Zometa)

Pamidronate in cases of HCM and cancer metastases, alendronate for osteoporosis

Hypercalcemia of malignancy (HCM), bone metastases in patients with breast cancer, osteolytic lesions in patients with multiple myeloma, and osteoporosis.

Zoledronic acid represents Insufficient evidence is available to evaluate the use of very poor value for money zoledronic acid for osteoporosis. when used for the treatment of bone metastases and osteolytic lesions. Oral voriconazole represents reasonable value for money. For patients who are intolerant or unresponsive to amphotericin B, it is cost saving to use oral voriconazole instead of liposomal amphotericin or caspofungin. Amphotericin B should remain the first-line treatment for suspected IA (unless renal impairment prevents usage). Where amphotericin B is contraindicated or must be discontinued due to intolerability or ineffectiveness; caspofungin should be delivered whilst the patient remains an inpatient and requires intravenous treatment. When the patient is fit for discharge, oral voriconazole should be given as an alternative to IV caspofungin. If patients are unable to be administered an oral formulation, caspofungin is cheaper than intravenous voriconazole and lipid amphotericin.

Voriconazole (Vfend) $22,000/QALY $46,000/QALY if only oral voriconazole used.

Amphotericin B

Invasive Aspergillosis (IA).

Final version distributed $28,000/QALY - $72,000/ in March 2004. QALY (depending on improvement in survival).

Part IIIb – Preliminary Pharmaceutical Assessments

Preliminary pharmaceuticals assessments are undertaken for individual DHBs within shorter timeframes. These assessments are available for DHBs to access via a secure website: www.pharmac.govt. nz/hpad. To obtain a password for the website, please contact either Rachel Grocott (04 916 7535; rachel.grocott@pharmac.govt.nz) or Ginny Priest (04 916 7568; ginny.priest@pharmac.govt.nz) Date Completed 2005 2004 2004

Pharmaceutical

Indication(s) Assessed

Recombinant activated factor Vlla (Nevoseven)

Non-haemophilic bleeding.

Palizumab (Synagis)

Prevention of serious lower respiratory tract disease caused by respiratory syncytial virus (RSV) in infants at high-risk of RSV disease.

Levosimendan (Simdax)

Severe low-output heart failure.

The Hospital Pharmaceutical Assessment Process (HPAP)

The Hospital Pharmaceutical Assessment process (HPAP) involves concurrent (or as near as possible) assessments by PHARMAC of pharmaceuticals assessed by DHB Hospitals. It relies on pharmaceutical suppliers and DHBs submitting applications on new hospital pharmaceuticals to PHARMAC for national assessment. The aims of the HPAP are to: • facilitate the introduction of economic analysis into hospital assessments for pharmaceuticals; • reduce duplication of work; • promote dialogue between DHBs; • facilitate review; • improve the consistency and quality of assessments; and • improve consistency of access to pharmaceuticals. National assessment by PHARMAC does not confer any obligation on DHBs to fund or not to fund new pharmaceuticals. Hospitals may commence funding of the new pharmaceuticals prior to any PHARMAC review and may continue to do so irrespective of any recommendation PHARMAC may make following review.

Part IV – Discretionary Community Supply Pharmaceuticals

Chemical and presentation ALBENDAZOLE Tab 200 mg Brand Chemical and presentation Brand CEFOTAXIME SODIUM Inj 500 mg Inj 1 g For any indication approved by the hospital service, with review at 6 weeks. CEFOXITIN SODIUM Powder for injection 1 g For any indication approved by the hospital service, with review at 6 weeks. CEFTAZIDIME Inj 500 mg Inj 1 g Inj 2 g For any indication approved by the hospital service, with review at 6 weeks. CEFTRIAXONE SODIUM Inj 1 g For any indication approved by the hospital service, with review at 6 weeks. CEFUROXIME AXETIL Tab 250 mg Oral liq 125 mg per 5 ml Up to 2 weeks supply for any appropriate indication CEFUROXIME SODIUM Inj 250 mg Inj 750 mg Inj 1.5 g For any indication approved by the hospital service, with review at 6 weeks. CHLORHEXIDINE Eye drops 0.02% For a period of 3 months for treatment of acanthamoeba keratitis. CIPROFLOXACIN Oral liq 5% Oral liq 10% Up to 6 weeks supply for any appropriate indication CLOPIDOGREL Tab 75 mg Plavix Up to 4 weeks supply post stenting. Not to be funded for acute coronary syndrome or transient ischaemic attacks

Albenza Zentel Indefinite supply to cover treatment of hydatid disease, strongyloidiasis, toxocariasis, ancylostomiasis, neurocysticerosis and schistosomiasis (where first line treatment has failed) until EC funding is approved (Section 29) AMIKACIN SULPHATE Inj 250 mg per ml, 2 ml For any indication approved by the hospital service, with review at 6 weeks AMOXYCILLIN WITH CLAVULANIC ACID Inj 600 mg, 500 mg with 100 mg clavulanic acid Inj 1.2 g, 1000 mg with 200 mg clavulanic acid For any indication approved by the hospital service, with review at 6 weeks AMPHOTERICIN B Inj 50 mg Oral liq 100 mg per ml (non-liposomal only) Up to 6 weeks supply for any appropriate indication AZTREONAM Inj 1 g For any indication approved by the hospital service, with review at 6 weeks. BENZATHINE PENICILLIN Inj 1.2 mega u per 2ml For prophylaxis of endocarditis BENZYLPENICILLIN SODIUM (PENICILLIN G) Inj 1 mega u For any indication approved by the hospital service, with review at 8 weeks. CEFAMANDOLE NAFATE Inj 500 mg Inj 1 g For any indication approved by the hospital service, with review at 8 weeks. CEFAZOLIN SODIUM Inj 500 mg Inj 1 g For any indication approved by the hospital service, with review at 8 weeks. CEFEPIME HYDROCHLORIDE Inj 1 g, 15 ml Inj 2 g, 77 ml For any indication approved by the hospital service, with review at 6 weeks.

Chemical and presentation CYCLOSPORIN Cap 25 mg Cap 50 mg Cap 100 mg Oral liq 100 mg per ml For aplastic anaemia

Brand

Chemical and presentation

Brand

Gengraf Neoral Gengraf Neoral Gengraf Neoral Gengraf Neoral

DEXTROSE Inj 5%, 10 ml Where required for antibiotic treatment funded under DCS or HEC ENOXAPARIN SODIUM Inj 20 mg per 0.2 ml Clexane Inj 40 mg per 0.4 ml Clexane Inj 60 mg per 0.6 ml Clexane Inj 80 mg per 0.8 ml Clexane Inj 100 mg per ml Clexane Inj 120 mg per 0.8 ml Clexane Inj 150 mg per ml Clexane For the treatment of venous thromboembolism (VTE) for a maximum of 14 days or until a stabilised therapeutic INR is established. For a maximum treatment period from the time of diagnosis to 8 weeks post partum for a confirmed thromboembolic event during pregnancy. For prophylaxis of thromboembolism for patients considered high risk after consultation with a specialist from diagnosis of pregnancy to 8 weeks post partum. For a maximum treatment period from diagnosis of pregnancy to 8 weeks post partum for women normally maintained on long-term oral anticoagulation who are at very high risk of thromboembolism. For the treatment for a maximum of 7 days pre and post operatively for patients on oral anticoagulants requiring surgical intervention in a public hospital or until an appropriate therapeutic INR level is reached. For a maximum of 14 days treatment in high-risk patients post pelvic, colo-rectal and major orthopaedic surgery. For a maximum of 7 days treatment for patients with an acute coronary syndrome (ACS) awaiting further hospital intervention. For a maximum of 14 days treatment post cardioversion in non anticoagulated patients with atrial fibrillation or until appropriate therapeutic INR level is reached. For treatment of malignancy - associated venous thromboembolism. ERTAPENEM SODIUM Inj 1 g For any indication approved by the hospital service, with review at 6 weeks. FILGRASTIM Inj 300 µg per 0.5 ml prefilled syringe Neupogen Inj 300 µg per 1 ml vial Neupogen Inj 480 µg per 0.5 ml prefilled syringe Neupogen Indefinite supply for any appropriate indication for the management of patients with cancer.

DALTEPARIN SODIUM Inj 2,500 IU per 0.2 ml Fragmin Inj 5,000 IU per 0.2 ml Fragmin Inj 7,500 IU per 0.75 ml Fragmin Inj 10,000 IU per 0.4 ml Fragmin Inj 10,000 IU per 1 ml Fragmin Inj 12,500 IU per 0.5 ml Fragmin Inj 15,000 IU per 0.6 ml Fragmin Inj 18,000 IU per 0.72 ml Fragmin For the treatment of venous thromboembolism (VTE) for a maximum of 14 days or until a stabilised therapeutic INR is established. For a maximum treatment period from the time of diagnosis to 8 weeks post partum for a confirmed thromboembolic event during pregnancy. For prophylaxis of thromboembolism for patients considered high risk after consultation with a specialist from diagnosis of pregnancy to 8 weeks post partum. For a maximum treatment period from diagnosis of pregnancy to 8 weeks post partum for women normally maintained on long-term oral anticoagulation who are at very high risk of thromboembolism. For the treatment for a maximum of 7 days pre and post operatively for patients on oral anticoagulants requiring surgical intervention in a public hospital or until an appropriate therapeutic INR level is reached. For a maximum of 14 days treatment in high-risk patients post pelvic, colo-rectal and major orthopaedic surgery. For a maximum of 7 days treatment for patients with an acute coronary syndrome (ACS) awaiting further hospital intervention. For a maximum of 14 days treatment post cardioversion in non anticoagulated patients with atrial fibrillation or until appropriate therapeutic INR level is reached. For treatment of malignancy - associated venous thromboembolism. DEMECLOCYCLINE Cap 150 mg Ledermycin Indefinite supply for SIADH (syndrome of inappropriate anti diuretic hormone) (Section 29)

Chemical and presentation

Brand

Chemical and presentation

Brand

FLUCLOXACILLIN SODIUM Inj 250 mg Inj 500 mg Inj 1g For any indication approved by the hospital service, with review at 8 weeks. FLUCONAZOLE Inj 100 mg per 50 ml For any indication approved by the hospital service, with review at 6 weeks. FORTIFIED EYE DROPS Up to 4 weeks supply of proprietary eyedrops fortified with any appropriate anti-infective agent for the treatment of severe corneal or eye surface infections FOSCARNET Inj 24 mg per ml IV soln Indefinite supply for any appropriate indication GANCICLOVIR Inj 500 mg Cymevene For prophylaxis and treatment of CMV-associated disease in immunocompromised patients and following organ transplant.

LENOGRASTIM Inj 13.4 million iu vial Granocyte Inj 33.6 million iu vial Granocyte Indefinite supply for any appropriate indication for the management of patients with cancer. LIGNOCAINE Viscous solution 2% For patients with head, neck and oesophageal cancer for up to 9 weeks following radiation therapy. MEROPENEM Inj 500 mg Inj 1 g For any indication approved by the hospital service, with review at 6 weeks. METHOXSALEN Cap 10 mg Oxsoralen Tab 10 mg Methoxypsaralen Indefinite supply for PUVA – psoralen plus ultraviolet a (UVA) therapy for severe, disabling psoriasis prephototherapy. MINOXIDIL Tab 2.5 mg Loniten Tab 5 mg Loniten Tab 10 mg Loniten Indefinite supply for the treatment of severe hypertension that is resistant to other anti-hypertensives or where alternatives are not tolerated (Section 29) MOLGRAMOSTIM Inj 300 µg Leucomax Indefinite supply for any appropriate indication for the management of patients with cancer. NETILMICIN Inj 150 mg per 1.5 ml Up to 2 weeks supply for any appropriate indication (extension for up to 6 weeks supply for endocarditis should be applied for under Hospital EC) NIMODIPINE Tab 30mg Up to 21 days supply post sub-arachnoid haemorrhage ONDANSETRON HYDROCHLORIDE Tab 4 mg Zofran Tab 8 mg Zofran Tab dispersible 4 mg Zofran Zydis Tab dispersible 8 mg Zofran Zydis For treatment of patients with hyperemesis gravidarum for the term of the pregnancy following failure of other antiemetic regimens.

GENTAMICIN SULPHATE Inj 40 mg per ml, 2 ml Indefinite supply for any indication approved by the hospital service. HEPARINISED SALINE Inj 10 iu per ml, 5 ml Inj 100 iu per ml, 5 ml For the maintenance of IV lines HYOSCINE (Scopolamine) Patches 1.5 mg Scopoderm TTS Up to 6 months supply for symptom control in terminally ill patients IMIPENEM WITH CILASTATIN Inj 500 mg with cilastin 500 mg For any indication approved by the hospital service, with review at 6 weeks. ITRACONAZOLE Oral liq 10 mg per ml Up to 3 months supply for use in liver transplant patients IVERMECTIN Tab 6 mg Indefinite supply for the treatment of filaricides, cutaneous larva migrans (creeping eruption) and Strongyloidiasis (Section 29)

Chemical and presentation PAMIDRONATE DISODIUM Inj 3 mg per ml, 10 ml

Brand

Chemical and presentation

Brand

Pamisol Aredia Inj 6 mg per ml, 10 ml Pamisol Inj 9 mg per ml, 10 ml Pamisol For malignant hypercalcaemia, metastatic breast cancer – predominant lytic bone metastases, myeloma with lytic bone metastases, control of pain due to lytic bone metastases in addition to standard care (analgesics + radiotherapy), Gaucher disease with established bone disease. PENTAMIDINE Inj 300 mg Indefinite supply for any appropriate indication PHENINDIONE Tab 10 mg Tab 25 mg Tab 50 mg Indefinite supply for warfarin resistance anti-coagulation therapy (Section 29) PIPERACILLIN SODIUM Inj 2 g Inj 4 g For any indication approved by the hospital service, with review at 6 weeks. PIPERACILLIN WITH TAZOBACTAM Inj 4 g with tazobactam 500 mg For any indication approved by the hospital service, with review at 6 weeks. POLYHEXAMETHYLENE BIGUANIDE Eye drops 0.02% For a period of 3 months for treatment of acanthamoeba keratitis. PRAZIQUANTEL Tab (s29) 500 mg Cysticide For the treatment of worm infestations (Section 29) PRIMOQUIN Tab 2.5 mg Tab 5 mg Tab 7.5 mg Indefinite supply for any appropriate indication (Section 29) PYRIMETHAMINE Tab 25 mg (Section 29) For the treatment of toxoplasmosis in patients with HIV for a period of 3 months; For pregnant patients for the term of the pregnancy; For infants with congenital toxoplasmosis until 12 months of age.

SODIUM CHLORIDE Tab 600 mg Slow Sodium Indefinite supply for salt wasting nephropathy (Section 29) Inj 0.9% Where required for injection of antibiotic treatment funded under DCS or HEC SPECIAL FOOD SUPPLEMENT Powder, sachet 74 g Oral Impact Three sachets per day for 5-7 days prior to major gastrointestinal or head or neck surgery. Liquid, 237 ml Impact Advanced Recovery Vanilla and Chocolate Three packs of 237 mls per days for 5 to 7 days prior to major gastrointestinal or head or neck surgery. SULPHADIAZINE Tab 500 mg (Section 29) For the treatment of toxoplasmosis in patients with HIV for a period of 3 months; For pregnant patients for the term of the pregnancy; For infants with congenital toxoplasmosis until 12 months of age. TEICOPLANIN Inj 400 mg For any indication approved by the hospital service, with review at 6 weeks. TICARCILLIN DISODIUM WITH CLAVULANIC ACID Inj 3 g with clavulanic acid 0.1 g For any indication approved by the hospital service, with review at 6 weeks. TINZAPARIN SODIUM Inj 3,500 anti-Xa IU/0.35ml Innohep Inj 4,500 anti Xa IU/0.45ml Innohep Inj 10,000 anti Xa IU/0.5ml Innohep Inj 14,000 anti Xa IU/0.7ml Innohep Inj 18,000 anti Xa IU/0.9ml Innohep Inj 20,000 anti XaIU/ml, 2ml Innohep For the treatment of venous thromboembolism (VTE) for a maximum of 14 days or until a stabilised therapeutic INR is established. For a maximum treatment period from the time of diagnosis to 8 weeks post partum for a confirmed thromboembolic event during pregnancy. For prophylaxis of thromboembolism for patients considered high risk after consultation with a specialist from diagnosis of pregnancy to 8 weeks post partum. For a maximum treatment period from diagnosis of pregnancy to 8 weeks post partum for women normally

Chemical and presentation

Brand

Chemical and presentation

Brand

maintained on long-term oral anticoagulation who are at very high risk of thromboembolism. For the treatment for a maximum of 7 days pre and post operatively for patients on oral anticoagulants requiring surgical intervention in a public hospital or until an appropriate therapeutic INR level is reached. For a maximum of 14 days treatment in high-risk patients post pelvic, colo-rectal and major orthopaedic surgery. For a maximum of 7 days treatment for patients with an acute coronary syndrome (ACS) awaiting further hospital intervention. For a maximum of 14 days treatment post cardioversion in non anticoagulated patients with atrial fibrillation or until appropriate therapeutic INR level is reached. For treatment of malignancy - associated venous thromboembolism. TOBRAMYCIN Inj 40 mg per ml, 2 ml Indefinite supply for any indication approved by the hospital service. TRIMETHOPRIM Tab 100 mg Indefinite supply for any appropriate indication (Section 29) VALGANCICLOVIR Tab 450 mg Up to 14 weeks supply for cytomegalovirus (CMV) retinitis in immunocompromised patients and prophylaxis of CMV following solid organ transplant VANCOMYCIN HYDROCHLORIDE Inj 50 mg per ml, 10 ml For any indication approved by the hospital service, with review at 6 weeks. WATER Purified for inj Where required for injection of antibiotic treatment funded under DCS or HEC

INDEX

A Abacavir sulphate with lamivudine .............................28 Abbott Sevorane .......................................................68 Abciximab .................................................................28 Abilify .......................................................................30 Accupril ....................................................................65 Accuretic 10 .............................................................65 Accuretic 20 .............................................................65 Acetazolamide ..........................................................28 Aciclovir ...................................................................28 Acidex ......................................................................68 Actigall .....................................................................72 Activated charcoal.....................................................28 Actos ........................................................................63 Adalimumab........................................................28, 76 Adefin XL ..................................................................59 Adefovir dipivoxil .......................................................28 Adrenaline.................................................................28 Advantan ..................................................................56 Advate ......................................................................66 AFT-Leflunomide .......................................................52 Aggrastat ............................................................71, 76 Alanase.....................................................................31 Albendazole ..............................................................82 Albenza .....................................................................82 Aldara .......................................................................48 Alendronate sodium ..................................................28 Alendronate sodium with cholecalciferol ....................28 Alfacalcidol ...............................................................28 Allersoothe................................................................65 Allopurinol.................................................................29 Alprostadil.................................................................29 Amantadine hydrochloride .........................................29 AmBisome ................................................................53 Amikacin sulphate ...............................................29, 82 Amikin ......................................................................29 Amiloride ..................................................................29 Amiloride with hydrochlorothiazide ............................29 Aminophylline ...........................................................29 Amirol .......................................................................29 Amisulpride...............................................................29 Amitrip ......................................................................29 Amitriptyline ..............................................................29 Amizide.....................................................................29 Amlodipine................................................................29 Amoxycillin ...............................................................29 Amoxycillin clavulanate .............................................30 Amoxycillin with clavulanic acid ................................82 Amphotericin B .........................................................82 Anastrozole-DP .........................................................30 Androderm................................................................71 Anexate.....................................................................44 Antabuse ..................................................................40 Antinaus ...................................................................65 Antithymocyte globulin (equine) ................................30 Apo-Allopurinol .........................................................29 Apo-Amlodipine ........................................................29 Apo-Amoxi ................................................................29 Apo-Captopril ............................................................33 Apo-Doxazosin..........................................................40 Apo-Gliclazide ...........................................................46 Apomorphine hydrochloride ......................................30 Apo-Nadolol ..............................................................58 Apo-Oxybutynin ........................................................61 Apo-Prazo.................................................................64 Apo-Prednisone ........................................................64 Apo-Terbinafine.........................................................71 Apo-Zopiclone...........................................................74 Apresoline.................................................................47 Aqueous ...................................................................30 Arava ........................................................................52 Aredia .......................................................................85 Aripiprazole ...............................................................30 Aristocort ..................................................................72 Aromasin ..................................................................42 Arrow-Azithromycin ..................................................31 Arrow-Citalopram ......................................................36 Arrow-Lamotrigine ....................................................52 Arrow-Metformin.......................................................55 Arrow-Nifedipine XR ..................................................59 Arrow-Norfloxacin .....................................................59 Arrow Ranitidine........................................................66 Arrow-Roxithromycin ................................................67 Arrow-Simva .............................................................68 Arrow-Sumatriptan ....................................................70 Asacol ......................................................................55 Aspen-Adrenaline ......................................................28 Aspen Ciprofloxacin ..................................................36 Asthalin ....................................................................67 Atacand ....................................................................33 Atazanavir sulphate ...................................................30 Atenolol ....................................................................30 ATGAM .....................................................................30 Ativan .......................................................................54 Atracurium besylate ..................................................30 Atropine sulphate ......................................................31 Atropt .......................................................................31 Augmentin ................................................................30 Avastin .....................................................................75 Avelox.......................................................................77 Azithromycin .............................................................31 Aztreonam ................................................................82 B Baclofen ...................................................................31 Basiliximab ...............................................................31 Beclomethasone dipropionate....................................31 Benzathine benzylpenicillin ........................................31 87

Benzathine penicillin ..................................................82 Benzylpenicillin sodium .......................................31, 82 Beractant ..................................................................31 Betadine....................................................................64 Betadine Skin Prep ....................................................64 Betagan ....................................................................52 Betahistine dihydrochloride........................................31 Betamethasone valerate ............................................31 Beta Scalp ................................................................31 Bevacizumab ............................................................75 Bezafibrate ................................................................31 Bezalip Retard ...........................................................31 Bicalox......................................................................31 Bicalutamide .............................................................31 Bicillin LA..................................................................31 Biodone ....................................................................55 Biodone Extra Forte ...................................................55 Biodone Forte............................................................55 Bisacodyl ..................................................................31 Blenoxane .................................................................31 Bleomycin sulphate ...................................................31 Botox ........................................................................37 Brimonidine tartarate .................................................32 Budesonide ...............................................................32 Bumetanide...............................................................32 Bupafen ....................................................................32 Bupivacaine hydrochloride.........................................32 Bupivacaine hydrochloride with fentanyl ....................32 Burinex .....................................................................32 Buscopan .................................................................48 Buspirone hydrochloride............................................32 Butacort aqueous ......................................................32 C Caffeine citrate ..........................................................32 Calcipotriol................................................................32 Calcitonin..................................................................32 Calcitriol ...................................................................33 Calcitriol-AFT ............................................................33 Calcium ....................................................................33 Calcium folinate ........................................................33 Calcium Folinate Ebewe.............................................33 Calcium gluconate ....................................................33 Calcium polystyrene sulphonate ................................33 Calcium Resonium ....................................................33 Cal-d-Forte................................................................35 Calsource .................................................................33 Camptosar ................................................................51 Candesartan..............................................................33 Capecitabine .............................................................33 Capsaicin ..................................................................33 Captopril ...................................................................33 Carboplatin ...............................................................34 Carboplatin Ebewe ....................................................34 Carbosorb-X .............................................................28 Cardinol LA ...............................................................65 88

Cardizem CD .............................................................40 Carvedilol ..................................................................34 Catapres ...................................................................37 Catapres-TTS-1 ........................................................37 Catapres-TTS-2 ........................................................37 Catapres-TTS-3 ........................................................37 Cefaclor monohydrate ...............................................34 Cefamandole nafate ..................................................82 Cefazolin sodium ................................................34, 82 Cefepime hydrochloride.......................................34, 82 Cefotaxime................................................................34 Cefotaxime Sandoz ...................................................34 Cefotaxime sodium ...................................................82 Cefoxitin sodium .................................................34, 82 Ceftazidime .........................................................34, 82 Ceftriaxone sodium .............................................34, 82 Cefuroxime axetil.................................................34, 82 Cefuroxime sodium .............................................35, 82 Celebrex....................................................................77 Celecoxib ..................................................................77 Celiprolol ..................................................................35 CellCept ....................................................................58 Celol .........................................................................35 Cetirizine-AFT............................................................35 Cetirizine hydrochloride .............................................35 Chloramphenicol .......................................................35 Chlorhexidine ......................................................35, 82 Chlorothiazide ...........................................................35 Chlorsig ....................................................................35 Chlorthalidone ...........................................................35 Cholecalciferol ..........................................................35 Cilazapril ...................................................................35 Cilazapril with hydrochlorothiazide .............................35 Cilicaine ....................................................................65 Cilicaine VK...............................................................63 Ciprofloxacin .......................................................35, 36 Cisplatin....................................................................36 Cisplatin Ebewe.........................................................36 Citalopram hydrobromide ..........................................36 Citanest ....................................................................64 Cladribine..................................................................36 Clarithromycin...........................................................36 Clexane .....................................................................83 Clindamycin ..............................................................36 Clobestasol propionate ..............................................36 Clomazol...................................................................37 Clomiphene citrate ....................................................36 Clomipramine hydrochloride ......................................36 Clonazepam ..............................................................36 Clonidine...................................................................37 Clopidogrel .........................................................36, 37 Clopine .....................................................................37 Clopixol.....................................................................74 Clopress ...................................................................36 Clostridum botulinum ................................................37 Clotrimazole ..............................................................37

Clozapine ..................................................................37 Clozaril .....................................................................37 Cocaine ....................................................................37 Codeine phosphate ...................................................37 Colaspase (L-asparaginase) ......................................37 Colchicine .................................................................37 Colgout .....................................................................37 Colifoam ...................................................................47 Colistin – Link ...........................................................38 Colistin sulphomethate ..............................................38 Colofac .....................................................................54 Coloxyl .....................................................................63 Combivent ................................................................68 Comtan .....................................................................41 Concerta ...................................................................56 Condyline..................................................................63 Crystacide.................................................................47 Curosurf ...................................................................63 Cyclizine hydrochloride .............................................38 Cyclizine Lactate .......................................................38 Cycloblastin ..............................................................38 Cyclophosphamide ...................................................38 Cyclosporin.........................................................38, 83 Cyklokapron ..............................................................72 Cymevene...........................................................45, 84 Cyproterone acetate ..................................................38 Cysticide...................................................................85 Cytarabine ................................................................38 D Dacarbazine ..............................................................38 Daclizumab ...............................................................38 Daivonex ...................................................................32 Daktarin ....................................................................57 Dalacin C ..................................................................36 Dalteparin sodium ...............................................38, 83 Danazol.....................................................................39 Dantrium ...................................................................39 Dantrium IV ...............................................................39 Dantrolene sodium ....................................................39 Daunorubicin ............................................................39 Demeclocycline ........................................................83 Depo-Medrol .............................................................56 Depo-Medrol with Lidocaine ......................................56 Depo-Testosterone....................................................71 Dermol......................................................................36 Desferrioxamine mesylate .........................................39 Desflurane ................................................................78 Desmopressin ...........................................................39 Desmopressin PH&T .................................................39 De-Worm ..................................................................54 Dexamethasone ........................................................39 Dexamethasone sodium phosphate ...........................39 Dexamphetamine sulphate.........................................39 Dextran 70 with sodium chloride ...............................39 Dextrose .............................................................39, 83

Diamox .....................................................................28 Diatol ........................................................................71 Diazepam..................................................................39 Diclax .......................................................................39 Diclofenac sodium ....................................................39 Didronel ....................................................................42 Diflucan POS.............................................................43 Dilatrend ...................................................................34 Diltiazem hydrochloride .............................................40 Dilzem ......................................................................40 Dinoprostone ............................................................40 Diprivan ....................................................................65 Dipyridamole.............................................................40 Disulfiram .................................................................40 Diurin 40 ...................................................................45 Diurin 500 .................................................................45 Docetaxel ..................................................................40 Docusate sodium with sennosides ............................40 Dopamine hydrochloride ...........................................40 Dopress ....................................................................40 Dothiepin hydrochloride.............................................40 Doxazosin mesylate ..................................................40 Doxine ......................................................................40 Doxorubicin ..............................................................40 Doxorubicin Ebewe ...................................................40 Doxycycline hydrochloride.........................................40 DP-Anastrozole .........................................................30 D-Penamine ..............................................................62 Drotrecogin alfa activated ..........................................78 Dr Reddy’s Omeprazole.............................................60 Dr Reddy’s Pantoprazole ...........................................62 Duovisc ....................................................................69 Duphalac ..................................................................51 Duride .......................................................................51 Dysport .....................................................................37 D-Zol ........................................................................39 E Efexor .......................................................................77 Efexor XR ..................................................................73 Efudix .......................................................................44 Eligard ......................................................................52 Elocon ......................................................................57 Eloxatin .....................................................................61 EMLA........................................................................53 Emtricitabine .............................................................40 Emtriva .....................................................................40 Emulsifying ointment .................................................41 E-Mycin ....................................................................41 Enbrel .................................................................42, 76 Endoxan....................................................................38 Enfuvirtide .................................................................41 Enoxaparin sodium....................................................83 Entacapone ...............................................................41 Ephedrine sulphate ....................................................41 Epirubicin..................................................................41 89

Epirubicin Ebewe.......................................................41 Eprex ........................................................................42 Eptifibatide ................................................................41 Ergometrine maleate .................................................41 Ertapenem sodium ..............................................41, 83 Erythrocin IV .............................................................41 Erythromycin ethyl succinate .....................................41 Erythromycin lactobionate .........................................41 Erythropoietin alpha...................................................42 Erythropoietin beta ....................................................42 etanercept .................................................................76 Etanercept.................................................................42 Etidrate .....................................................................42 Etidronate disodium ..................................................42 Etoposide..................................................................42 Exemestane ..............................................................42 F Felo 5 ER ..................................................................42 Felo 10 ER ................................................................42 Felodipine .................................................................42 Femara .....................................................................52 Fenpaed ....................................................................48 Fentanyl ....................................................................42 Ferodan ....................................................................43 Ferro-F-Tabs .............................................................43 Ferro-tab ...................................................................43 Ferrous Fumarate ......................................................43 Ferrous fumarate with folic acid .................................43 Ferrous sulphate .......................................................43 Ferrum H...................................................................51 Fibalip .......................................................................31 Filgrastim ............................................................43, 83 Finasteride ................................................................43 Fintral .......................................................................43 Flagyl ........................................................................57 Flagyl - S ..................................................................57 Fleet..........................................................................31 Fleet Phosphate Enema .............................................68 Florinef .....................................................................44 Fluanxol ....................................................................44 Flucloxacillin .............................................................43 Flucloxacillin sodium ...........................................43, 84 Flucloxin ...................................................................43 Flucon.......................................................................44 Fluconazole .........................................................43, 84 Fludara......................................................................44 Fludarabine ...............................................................44 Fludarabine phosphate ..............................................44 Fludrocortisone acetate .............................................44 Flumazenil.................................................................44 Fluocortolone caproate with fluocortolone pivalate and cinchocaine ..............................................................44 Fluorometholone .......................................................44 Fluorouracil Ebewe ....................................................44 Fluorouracil sodium...................................................44 90

Fluox.........................................................................44 Fluoxetine hydrochloride ............................................44 Flupenthixol decanoate ..............................................44 Fluphenazine decanoate ............................................44 Flutamide ..................................................................45 Flutamin ....................................................................45 Fluticasone with salmeterol .......................................45 Foban .......................................................................45 Folic acid ..................................................................45 Forthane ...................................................................51 Fortified eyedrops......................................................84 Fortum ......................................................................34 Fosamax ...................................................................28 Fosamax Plus ...........................................................28 Foscarnet ..................................................................84 Fragmin ..............................................................38, 83 Frusemide .................................................................45 Fucidin ......................................................................45 Fucithalmic ...............................................................45 Fusidic acid...............................................................45 Fuzeon ......................................................................41 G Gabapentin ...............................................................45 Gadobendate dimeglumine ........................................45 Ganciclovir..........................................................45, 84 Gastrografin ..............................................................54 Gastrosoothe ............................................................48 Gatifloxacin ...............................................................77 Gelatin plasma replacer .............................................45 Gelofusine.................................................................45 Gemcitabine hydrochloride ........................................45 Gemzar .....................................................................45 Gengraf.....................................................................83 Genoptic ...................................................................46 Genox .......................................................................70 Gentamicin sulphate ............................................46, 84 Gliclazide ..................................................................46 Glipizide ....................................................................46 Glivec .......................................................................48 Glucose ....................................................................46 Glucose with sodium, potassium, magnesium, chloride, acetate and gluconate ..............................46 Glucose with sodium, potassium, magnesium, chloride and acetate ...............................................46 Glycerol ....................................................................46 Glyceryl trinitrate .......................................................46 Glypressin.................................................................71 Goserelin acetate ......................................................47 Granocyte .................................................................84 H Habitrol .....................................................................59 Haemaccel................................................................45 Haldol .......................................................................47 Haldol Concentrate ....................................................47

Haloperidol ...............................................................47 Haloperidol decanoate ...............................................47 Healon Clear .............................................................69 Healon GV.................................................................69 Heparinised saline ...............................................47, 84 Heparin Sodium ........................................................47 Heparin with sodium chloride ....................................47 Hepsera ....................................................................28 Herceptin ..................................................................72 Holoxan ....................................................................48 Humalog Mix 25........................................................49 Humalog Mix 50........................................................49 Humira................................................................28, 76 HumiraPen ................................................................28 Hybloc ......................................................................51 Hydralazine ...............................................................47 Hydrea ......................................................................48 Hydrocortisone .........................................................47 Hydrocortisone acetate .............................................47 Hydrocortisone butyrate ............................................47 Hydrocortisone with miconazole ................................47 Hydrogen peroxide ....................................................47 Hydroxocobalamin ....................................................48 Hydroxychloroquine sulphate.....................................48 Hydroxyurea .............................................................48 Hygroton...................................................................35 Hyoscine ..................................................................84 Hyoscine Hydrobromide ............................................48 Hyoscine N-butylbromide ..........................................48 Hyoscine (scopolamine)............................................48 Hypnovel ..................................................................57 Hypromellose............................................................48 I Ibiamox.....................................................................29 Ibuprofen ..................................................................48 Idarubicin hydrochloride ............................................48 Ifosfamide.................................................................48 Imatinib mesylate ......................................................48 Imipenem with cilastatin ......................................48, 84 Imipramine hydrochloride ..........................................48 Imiquimod ................................................................48 Indapamide ...............................................................48 infliximab ..................................................................76 Infliximab ..................................................................48 Inhibace ....................................................................35 Inhibace Plus ............................................................35 Innohep ....................................................................85 Insulin glargine ..........................................................49 Insulin lispro with insulin lispro protamine ..................49 Insulin pen needles....................................................49 Insulin syringes, disposable with attached needle ......49 Integrilin ....................................................................41 Invanz .......................................................................41 Invirase .....................................................................68 Iodixanol ...................................................................49

Iohexol ......................................................................49 Ioscan ......................................................................69 Ipratropium bromide ..................................................50 Ipratropium Steri-Neb ................................................50 Irinotecan..................................................................51 Iron polymaltose .......................................................51 Ismo-20 ....................................................................51 Isoflurane ..................................................................51 Isoniazid ...................................................................51 Isoptin ......................................................................73 Isosorbide mononitrate..............................................51 Isotane 10.................................................................51 Isotane 20.................................................................51 Isotretinoin ................................................................51 Itraconazole ........................................................50, 51 Ivermectin ...........................................................50, 51 K Kaletra ......................................................................53 Kenacomb ................................................................72 Kenacort-A................................................................72 Kenacort-A40............................................................72 Ketoconazole ............................................................51 Kivexa .......................................................................28 Klacid .......................................................................36 Klamycin...................................................................36 Klean-Prep ................................................................63 Kogenate FS..............................................................66 Konakion ..................................................................63 Konakion MM............................................................63 Konsyl-D...................................................................58 L Labetalol ...................................................................51 Lactulose ..................................................................51 Lamictal ....................................................................52 Lamotrigine...............................................................52 Lansoprazole ............................................................52 Lantus ......................................................................49 Laxsol .......................................................................40 Lax-Tabs...................................................................31 Ledermycin ...............................................................83 Leflunomide ..............................................................52 Lenograstim ..............................................................84 Letrozole ...................................................................52 Leucomax .................................................................84 Leunase ....................................................................37 Leuprorelin................................................................52 Leustatin ...................................................................36 Levobunolol ..............................................................52 Levodopa with benserazide .......................................53 Levophed ..................................................................59 Lignocaine ..........................................................53, 84 Lignocaine hydrochloride ..........................................53 Lignocaine hydrochloride with adrenaline...................53 Lignocaine with chlorhexidine ....................................53 91

Lignocaine with prilocaine .........................................53 Linezolid ...................................................................79 Liposomal amphotericin ............................................53 Liquifilm Forte ...........................................................63 Liquifilm Tears ..........................................................63 Locoid Crelo .............................................................47 Locoid lipocream ......................................................47 Locoid Lipocream .....................................................47 Locoid ointment ........................................................47 Logem ......................................................................52 Loniten .....................................................................84 Lopinavir with ritonavir ..............................................53 Loraclear Hayfever Relief...........................................54 Lorapaed ..................................................................54 Loratadine.................................................................54 Lorazepam ................................................................54 Losec .......................................................................60 Losec IV ...................................................................60 Lovir .........................................................................28 Loxamine ..................................................................62 Lucrin Depot .............................................................52 Lycinate ....................................................................46 Lyderm .....................................................................62 M Mabthera ..................................................................67 Macrogol 3350 .........................................................54 Madopar 62.5 ...........................................................53 Madopar 125 ............................................................53 Madopar 250 ............................................................53 Madopar Dispersible .................................................53 Madopar HBS ...........................................................53 Magnesium sulphate .................................................54 Magnevist .................................................................55 Mannitol....................................................................54 Marcain ....................................................................32 Marcain Heavy ..........................................................32 Marcain Isobaric .......................................................32 Marine Blue Lotion SPF 30+ .....................................70 Maxalt Melt ...............................................................67 Maxipime ..................................................................34 Mebendazole.............................................................54 Mebeverine hydrochloride .........................................54 Medrol ......................................................................56 Medroxyprogesterone acetate....................................54 Megace.....................................................................54 Megestrol acetate......................................................54 Meglumine diatrizoate with sodium amidotrizoate ......54 Meglumine gadopentetate..........................................55 Meropenem ........................................................55, 84 Merrem .....................................................................55 Mesalazine ................................................................55 m-Eslon ....................................................................58 Mesna ......................................................................55 Metalyse ...................................................................75 Metamide..................................................................56 92

Metformin hydrochloride ...........................................55 Methadone hydrochloride ..........................................55 Methatabs .................................................................55 Methoblastin .............................................................55 Methopt ....................................................................48 Methotrexate .............................................................55 Methotrexate Ebewe ..................................................55 Methoxsalen .............................................................84 Methylcellulose .........................................................56 Methyldopa ...............................................................56 Methyl hydroxybenzoate ............................................56 Methylphenidate hydrochloride ..................................56 Methylphenidate hydrochloride extended release ........56 Methylprednisolone ...................................................56 Methylprednisolone aceponate ..................................56 Methylprednisolone acetate .......................................56 Methylprednisolone acetate with lignocaine ...............56 Methylprednisolone sodium succinate .......................56 Metoclopramide hydrochloride ..................................56 Metoprolol tartrate .....................................................56 Metronidazole ...........................................................57 m-Fluconazole ..........................................................43 Miacalcic ..................................................................32 Miconazole nitrate .....................................................57 Micreme H ................................................................47 Microlax ....................................................................69 Midazolam ................................................................57 Minidiab ....................................................................46 Minirin ......................................................................39 Minoxidil ...................................................................84 Mitozantrone .............................................................57 Mitozantrone Ebewe ..................................................57 Mivacron ..................................................................57 Mivacurium ...............................................................57 Modecate..................................................................44 Mogine .....................................................................52 Molgramostim...........................................................84 Mometasone furoate .................................................57 Morphine hydrochloride.............................................57 Morphine sulphate.....................................................58 Morphine Tartrate ......................................................58 Movicol.....................................................................54 Moxifloxacin..............................................................77 Mucilaginous laxatives ..............................................58 Multihance ................................................................45 Mycobutin.................................................................66 Mycophenolate mofetil ..............................................58 N Nadolol .....................................................................58 Naloxone hydrochloride .............................................58 Naltrexone hydrochloride ...........................................58 Napamide .................................................................48 Naproxen sodium ......................................................58 Naropin .....................................................................67 Nausicalm.................................................................38

Navoban ...................................................................72 Neo-B12 ...................................................................48 Neoral .................................................................38, 83 NeoRecormon ...........................................................42 Neostigmine methylsulphate ......................................58 Neosynephrine HCL ..................................................63 Netilmicin..................................................................84 Neulastim .................................................................62 Neupogen .....................................................42, 43, 83 Neurontin ............................................................45, 78 Nevirapine .................................................................58 Nevoseven ................................................................80 Nicotine ....................................................................59 Nifedipine..................................................................59 Nilstat .......................................................................59 Nimodipine ...............................................................84 Nitroderm TTS 5........................................................46 Nitroderm TTS 10......................................................46 Nitrolingual pumpspray .............................................46 Nitronal .....................................................................46 Noradrenaline acid tartrate .........................................59 Norethisterone ..........................................................59 Norfloxacin ...............................................................59 Normison ..................................................................70 Norpress ...................................................................59 Nortriptyline hydrochloride.........................................59 Norvir .......................................................................67 Nupentin ...................................................................45 Nyefax Retard ...........................................................59 Nystatin ....................................................................59 O Octreotide .................................................................60 Olanzapine ................................................................60 Omeprazole...............................................................60 Omnipaque .........................................................49, 50 Ondansetron hydrochloride..................................60, 84 One-Alpha .................................................................28 Onkotrone .................................................................57 Oracort .....................................................................72 Oral Impact .........................................................70, 85 Oxaliplatin .................................................................61 Oxsoralen..................................................................84 Oxybutynin ................................................................61 Oxycodone Hydrochloride .........................................61 OxyContin .................................................................61 OxyNorm ..................................................................61 Oxytocin ...................................................................61 Oxytocin with ergometrine maleate ............................61 P Pacifen .....................................................................31 Pacific Atenolol .........................................................30 Pacific Buspirone ......................................................32 Paclitaxel ..................................................................61 Paclitaxel Ebewe .......................................................61

Palizumab .................................................................80 Pamidronate Disodium ........................................61, 85 Pamisol ..............................................................61, 85 Panadol ....................................................................62 Pancuronium bromide ...............................................61 Pantocid ...................................................................62 Pantoprazole .............................................................62 Papaverine hydrochloride ..........................................62 Paracare ...................................................................62 Paracare Double Strength ..........................................62 Paracare Junior .........................................................62 Paracetamol..............................................................62 Paroxetine hydrochloride ...........................................62 Paxam ......................................................................36 Pegfilgrastim .............................................................62 Penicillamine.............................................................62 Penicillin G ................................................................82 Pentamidine ..............................................................85 Pentasa ....................................................................55 Pentastarch...............................................................62 Peptisoothe ...............................................................66 Pergolide ..................................................................62 Perhexiline maleate ...................................................62 Permax .....................................................................62 Permethrin ................................................................62 Pethidine Hydrochloride ............................................63 Pexsig.......................................................................62 Phenate ....................................................................36 Phenindione ..............................................................85 Phenoxymethylpenicillin (Penicillin V) ........................63 Phentolamine Mesylate .............................................63 Phenylephrine hydrochloride .....................................63 Phytomenadione .......................................................63 Pinetarsol..................................................................70 Pioglitazone ..............................................................63 Piperacillin sodium ....................................................85 Piperacillin with tazobactam ......................................85 Piram-D ....................................................................63 Piroxicam..................................................................63 Plaquenil ...................................................................48 Plavix ..................................................................36, 37 Podophyllotoxin ........................................................63 Poloxamer ................................................................63 Polyethylene glycol with sodium sulphate ..................63 Polyhexamethylene biguanide ....................................85 Polyvinyl alcohol .......................................................63 Poractant Alfa ...........................................................63 Potassium chloride ...................................................63 Potassium chloride with glucose ...............................64 Potassium chloride with glucose and sodium chloride .....................................................64 Potassium chloride with sodium chloride ...................64 Povidone iodine ........................................................64 Praziquantel ..............................................................85 Prazosin hydrochloride ..............................................64 93

Prednisolone sodium phosphate ................................64 Prednisone................................................................64 Prilocaine hydrochloride ............................................64 Primaxin ...................................................................48 Primolut N.................................................................59 Primoquin .................................................................85 Procaine penicillin .....................................................65 Prochlorperazine .......................................................65 Prodopa ....................................................................56 Prograf .....................................................................70 Promethazine hydrochloride ......................................65 Pro-Pam ...................................................................39 Propofol ....................................................................65 Propranolol ...............................................................65 Propylene glycol .......................................................65 Prostin E2 .................................................................40 Prostin VR ................................................................29 Provera .....................................................................54 Pyrimethamine ..........................................................85 Pytazen SR ...............................................................40 Q Q 200 .......................................................................66 Q 300 .......................................................................66 Quetapel ...................................................................65 Quetiapine.................................................................65 Quinapril ...................................................................65 Quinapril with hydrochlorothiazide .............................65 Quinine sulphate .......................................................66 R RA-Morph .................................................................57 Ranbaxy-Cefaclor......................................................34 Ranitidine hydrochloride ............................................66 Rapamune ................................................................68 Rapilysin ...................................................................66 Recombinant activated factor Vlla ..............................80 Recombinant Factor VIII ............................................66 Recormon .................................................................42 Redipred ...................................................................64 ReFacto ....................................................................66 Regitine ....................................................................63 Remicade .....................................................48, 76, 78 Remifentanil hydrochloride ........................................66 ReoPro .....................................................................28 Requip ......................................................................67 Requip Follow-on Pack..............................................67 Requip Starter Pack...................................................67 Reteplase ..................................................................66 ReVia ........................................................................58 Rex Medical ..............................................................36 Reyataz.....................................................................30 Ridal .........................................................................66 Rifabutin ...................................................................66 Riodine .....................................................................64 Risperdal ..................................................................66 94

Risperdal Consta .................................................66, 76 Risperdal Quicklet .....................................................66 Risperidone...............................................................66 Ritonavir ...................................................................67 Rituximab .................................................................67 Rivotril ......................................................................36 Rizatriptan benzoate ..................................................67 Rocaltrol ...................................................................33 rofecoxib...................................................................77 Rofecoxib .................................................................77 Ropinirole Hydrochloride ...........................................67 Ropivacaine hydrochloride ........................................67 Ropivacaine hydrochloride with fentanyl ....................67 Roxithromycin...........................................................67 Rubifen .....................................................................56 Rubifen SR ...............................................................56 S Salamol ....................................................................67 Salapin .....................................................................67 Salbutamol................................................................67 Salbutamol with ipratropium bromide.........................68 Salicylic acid .............................................................68 Salmeterol ................................................................68 Sandimmun ..............................................................38 Sandostatin ...............................................................60 Sandostatin LAR .......................................................60 Sandoz .....................................................................31 Saqunavir..................................................................68 Scopoderm TTS ..................................................47, 48 Sebizole ....................................................................51 Serenace ..................................................................47 Seretide ....................................................................45 Seretide Accuhaler ....................................................45 Serevent ...................................................................68 Serevent Accuhaler ...................................................68 Seroquel ...................................................................65 Sevoflurane ...............................................................68 Sevredol ...................................................................58 Simdax .....................................................................80 Simulect ...................................................................31 SimvaRex .................................................................68 Simvastatin ...............................................................68 Sirolimus ..................................................................68 Siterone ....................................................................38 Slow-Lopresor ..........................................................56 Slow Sodium ............................................................85 Sodium acid phosphate .............................................68 Sodium alginate ........................................................68 Sodium Bicarbonate ..................................................69 Sodium chloride ..................................................69, 85 Sodium chloride with glucose....................................69 Sodium citrate with sodium lauryl sulphoacetate ........69 Sodium citro-tartrate .................................................69 Sodium diotrizoate ....................................................69 Sodium hyaluronate ..................................................69

Solian .......................................................................29 Solox ........................................................................52 Solu-Medrol ..............................................................56 Sonaflam ..................................................................58 Sotalol ......................................................................69 Span-K .....................................................................63 Special food supplement .....................................70, 85 Spiriva ......................................................................71 Spironolactone ..........................................................70 Spirotone ..................................................................70 Sporanox ..................................................................51 Staphlex ....................................................................43 StarQuin 10% ............................................................62 StarQuin 200 6% .......................................................62 Stesolid ....................................................................39 Streptase ..................................................................70 Streptokinase ............................................................70 Stromectol ................................................................51 Sulphadiazine ............................................................85 Sulphur, precipitated .................................................70 Sumagran .................................................................70 Sumatriptan ..............................................................70 Sunscreens, proprietary ............................................70 Suprane ....................................................................78 Survanta ...................................................................31 Suxamethonium chloride ...........................................70 Symmetrel ................................................................29 Synacthen.................................................................71 Synacthen Depot .......................................................71 Synagis ....................................................................80 Synermox .................................................................30 Syntocinon................................................................61 Syntometrine.............................................................61 Syrup (pharmaceutical grade) ...................................70 T Tacrolimus................................................................70 Tamoxifen citrate.......................................................70 Tar with triethanolamine lauryl sulphate and fluorescein ......................................................70 Taxotere....................................................................40 Teicoplanin ...............................................................85 Temazepam ..............................................................70 Temodal ...................................................................71 Temozolomide ..........................................................71 Tenecteplase.............................................................75 Tenofovir disoproxil fumarate ....................................71 Tequin ......................................................................77 Terbinafine ................................................................71 Terlipressin ...............................................................71 Testosterone .............................................................71 Testosterone cypionate .............................................71 Tetracosactrin ...........................................................71 Ticarcillin disodium with clavulanic acid ....................85 Tinzaparin sodium .....................................................85

Tiotropium bromide ...................................................71 Tirofiban ...................................................................76 Tirofiban hydrochloride..............................................71 Tobramycin.........................................................71, 86 Tofranil .....................................................................48 Tolbutamide ..............................................................71 Topamax...................................................................71 Topiramate................................................................71 Tracrium ...................................................................30 Tramadol hydrochloride.............................................72 Tramal ......................................................................72 Tramal 50 .................................................................72 Tramal 100 ...............................................................72 Tramal Retard ...........................................................72 Tranexamic acid ........................................................72 Trastuzumab .............................................................72 Tretinoin ...................................................................72 Triamcinolone acetonide ...........................................72 Triamcinolone acetonide with gramicidin, neomycin and nystatin ...........................................72 Triamizide .................................................................72 Triamterene with hydrochlorothiazide.........................72 Trichozole .................................................................57 Trimethoprim ......................................................72, 86 Tropisetron ...............................................................72 U Ultiva ........................................................................66 Ultraproct ..................................................................44 Ural...........................................................................69 Uromitexan ...............................................................55 Ursodeoxycholic Acid................................................72 V Valganciclovir ...........................................................86 Valoid (AFT) ..............................................................38 Vancomycin hydrochloride ..................................72, 86 Venlafaxine ...............................................................73 Ventolin ....................................................................67 Vepesid.....................................................................42 Verapamil hydrochloride ............................................73 Vergo 16 ...................................................................31 Verpamil ...................................................................73 Verpamil SR ..............................................................73 Vesanoid...................................................................72 Vfend ........................................................................79 Vinblastine Sulphate ..................................................73 Vincristine Sulphate...................................................73 Vinorelbine ................................................................73 Vinorelbine Ebewe .....................................................73 Vioxx ........................................................................77 Viramune Suspension ...............................................58 Viread .......................................................................71 Visipaque ..................................................................49 Vistil .........................................................................63 Vistil Forte .................................................................63 95

Voltaren ....................................................................39 Voltaren Ophtha ........................................................39 Voriconazole .............................................................79 W Water ..................................................................73, 86 Water with sodium, potassium, calcium and chloride .73 Water with sodium, potassium, calcium, bicarbonate and chloride ...........................................................73 Water with sodium, potassium, calcium, bicarbonate, chloride and glucose ..............................................73 Water with sodium, potassium, magnesium, chloride, acetate and gluconate ............................................74 X Xeloda ......................................................................33 Xigris ........................................................................78 Xylocaine ..................................................................53 Z Zantac.......................................................................66 Zavedos ....................................................................48

Zeldox .......................................................................74 Zenapax ....................................................................38 Zentel........................................................................82 Zetop ........................................................................35 Zinacef ......................................................................35 Zinc and castor oil .....................................................74 Zincaps .....................................................................74 Zinc sulphate.............................................................74 Zinnat .......................................................................34 Ziprasidone ...............................................................74 Zofran .................................................................60, 84 Zofran Zydis ........................................................60, 84 Zoladex .....................................................................47 Zoledronic acid ...................................................74, 79 Zometa ...............................................................74, 79 Zopiclone ..................................................................74 Zostrix HP .................................................................33 Zuclopenthixol decanoate ..........................................74 Zyprexa .....................................................................60 Zyprexa Zydis ............................................................60 Zyvox ........................................................................79

While care has been taken in compiling this Section H Update, Pharmaceutical Management Agency takes no responsibility for any errors or omissions and shall not be liable to any person for any damages or loss arising out of reliance by that person for any purpose on any of the contents of this Update. Errors and omissions brought to the attention of Pharmaceutical Management Agency will be corrected if necessary by an erratum or otherwise in the next edition of the Update.

Level 9 Cigna House 40 Mercer Street PO Box 10 254 Wellington New Zealand Telephone 64 4 460 4990 Facsimile 64 4 460 4995 http://www.pharmac.govt.nz Freephone information line (9 am – 4 pm weekdays)

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Title

Section H - effective 1 March 2009

Abstract

Contents Introducing PHARMAC …..2 Members of the PHARMAC Board ….2 Decision Criteria …2 PHARMAC and Section H of the Pharmaceutical Schedule ….3 The PHARMAC Hospital Team….3 PHARMAC’s clinical advisors …..4 Pharmacology and Therapeutics Advisory Committee (PTAC)…..4 Hospital Pharmaceuticals Advisory Committee…

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